Radiotherapy and breast reconstruction.
Indications for post mastectomy radiotherapy are widening to a larger group of mastectomy patients and breast reconstruction rates following mastectomy are rising all over the world, this leading breast surgeons to face breast reconstruction in a growing number of patients who will undergo radiotherapy. Increased morbidity is associated with all forms of breast reconstruction in the setting of postmastectomy radiotherapy and in patients who previously underwent chest wall radiotherapy. Different attitudes towards breast reconstruction in the radiotherapy setting are presented in literature. The level of evidence and quality of studies investigating breast reconstruction in the setting of PMRT and in patients who previously underwent chest wall radiotherapy are low. The reconstructive option in the radiotherapy setting must be tailored on the single patient according with patients' characteristics and wishes, always considering that the best reconstructive timing must be driven by the best oncological timing.


Water consumption reduces energy intake at a breakfast meal in obese older adults.
Water consumed before a meal has been found to reduce energy intake among nonobese older adults. However, it is unknown whether this effect is evident among overweight and obese older adults, a population who would benefit from strategies to improve energy intake regulation. Our purpose was to determine whether premeal water consumption reduces meal energy intake in overweight and obese older adults. Twenty-four overweight and obese adults (body mass index=34.3+/-1.2), mean age 61.3+/-1.1 years, were given an ad libitum standardized breakfast meal on two randomly assigned occasions. Thirty minutes before the meal, subjects were given either a 500-mL water preload or no preload. Energy intake at each meal was covertly measured. Meal energy intake was significantly less in the water preload condition as compared with the no-preload condition (500+/-32 vs 574+/-38, respectively; P=0.004), representing an approximate 13% reduction in meal energy intake. The percentage reduction in meal energy intake following the water preload was not related to sex, age, body mass index, or habitual daily water consumption (all P>0.05). Given the high prevalence of overweight and obesity among older adults, future studies should determine whether premeal water consumption is an effective long-term weight control strategy for older adults.


Bootstrap Aggregation for Model Selection in the Model-free Formalism.
The ability to make robust inferences about the dynamics of biological macromolecules using NMR spectroscopy depends heavily on the application of appropriate theoretical models for nuclear spin relaxation. Data analysis for NMR laboratory-frame relaxation experiments typically involves selecting one of several model-free spectral density functions using a bias-corrected fitness test. Here, advances in statistical model selection theory, termed bootstrap aggregation or bagging, are applied to 15N spin relaxation data, developing a multimodel inference solution to the model-free selection problem. The approach is illustrated using data sets recorded at four static magnetic fields for the bZip domain of the S. cerevisiae transcription factor GCN4.


Early response assessment in gastrointestinal stromal tumors with FDG PET scan 24 hours after a single dose of imatinib.
Gastrointestinal stromal tumors (GIST), rare mesenchymal tumors of the gastrointestinal tract, are gaining the interest of researchers because of the impressive metabolic response to the targeted molecular therapeutic drug imatinib mesylate. FDG PET is now routinely used to assess treatment response in cases of GIST because this has proven to give metabolic information, which demonstrates response earlier than anatomic imaging modalities. A 50-year-old man presented with abdominal pain and the CT scan showed a large lobulated heterogeneously enhancing mass in the abdomen. Fine needle aspiration cytology (FNAC) confirmed GIST with strong immunoreactivity to C-Kit protein. A baseline FDG PET done before initiation of therapy showed intense nonhomogenous FDG uptake in the mass (standard uptake value maximum, SUVmax of 13.45). A whole body FDG PET, repeated 24 hours after a single dose of imatinib mesylate 400 mg, showed a significant reduction in FDG uptake with a SUVmax of 4.26.


Progestin treatment in the dog. I. Effects on growth hormone, insulin-like growth factor I and glucose homeostasis.
The effects of two synthetic progestins, medroxyprogesterone acetate (MPA) and proligestone (PROL), on the release of growth hormone (GH) and glucose metabolism were studied in two groups of eight ovariohysterectomized dogs. Eight injections of long-acting progestins were administered at 3-week intervals. Recovery was studied in four dogs of each treatment group in the 6 months following cessation of progestin administration. Treatment with both MPA and PROL resulted in similar increases in plasma levels of GH and insulin-like growth factor I (IGF-I). The GH responses to both clonidine and growth hormone-releasing hormone became impaired. In neither treatment group did the elevated plasma GH levels decrease after administration of the synthetic somatostatin analogue SMS 201-995. The size and shape of the pituitary gland were not changed by progestin treatment. After cessation of progestin administration, basal plasma levels of GH and IGF-I did not return to pretreatment values. The GH response to growth hormone-releasing hormone remained impaired for at least 6 months after the last progestin administration. In both treatment groups, glucose homeostasis was sustained initially by increased insulin production. Prolonged treatment with MPA and PROL resulted in glucose intolerance. No amelioration was observed during the recovery period in either group. A small number of dogs developed diabetes mellitus. In more than 50% of the dogs in both treatment groups small mammary tumours developed. The recently discovered local production of GH probably played a role in mammary tumorigenesis.(ABSTRACT TRUNCATED AT 250 WORDS)


Agonist of growth hormone-releasing hormone enhances retinal ganglion cell protection induced by macrophages after optic nerve injury.
Optic neuropathies are leading causes of irreversible visual impairment and blindness, currently affecting more than 100 million people worldwide. Glaucoma is a group of optic neuropathies attributed to progressive degeneration of retinal ganglion cells (RGCs). We have previously demonstrated an increase in survival of RGCs by the activation of macrophages, whereas the inhibition of macrophages was involved in the alleviation on endotoxin-induced inflammation by antagonist of growth hormone-releasing hormone (GHRH). Herein, we hypothesized that GHRH receptor (GHRH-R) signaling could be involved in the survival of RGCs mediated by inflammation. We found the expression of GHRH-R in RGCs of adult rat retina. After optic nerve crush, subcutaneous application of GHRH agonist MR-409 or antagonist MIA-602 promoted the survival of RGCs. Both the GHRH agonist and antagonist increased the phosphorylation of Akt in the retina, but only agonist MR-409 promoted microglia activation in the retina. The antagonist MIA-602 reduced significantly the expression of inflammation-related genes Il1b, Il6, and Tnf Moreover, agonist MR-409 further enhanced the promotion of RGC survival by lens injury or zymosan-induced macrophage activation, whereas antagonist MIA-602 attenuated the enhancement in RGC survival. Our findings reveal the protective effect of agonistic analogs of GHRH on RGCs in rats after optic nerve injury and its additive effect to macrophage activation, indicating a therapeutic potential of GHRH agonists for the protection of RGCs against optic neuropathies especially in glaucoma.


Effect of luminance, contrast, and eccentricity on visual acuity in senile macular degeneration.
We examined the effect of luminance on low contrast visual acuity in six patients with mild reductions in vision due to senile macular degeneration (SMD) and in six normals of approximately the same age. At the highest luminance tested the SMD patients showed a reduction in acuity compared to the controls, with eccentricity and contrast effects clearly shown. The SMD patients had difficulty performing the acuity task at the lower luminances (0.26 and 0.75 cd/m2); they showed little or no increase in visual acuity with increasing contrast levels at the lower luminances. Acuity was slightly influenced by target eccentricity at these luminances. These data suggest that the adaptation mechanisms allowing the normal visual system to operate efficiently over a wide range of luminances are affected in SMD, even when clinically measured acuity is only moderately depressed.


Class II induction of human corneal fibroblasts by cell-free supernatants from HSV stimulated lymphocytes.
Lymphocytes obtained from patients with herpes simplex virus, type 1 (HSV) neutralizing antibodies were stimulated in vitro for 48 hr with heat inactivated HSV. Cell-free supernatant from these cultures was added to autologous or allogeneic HLA-DR-negative stromal (fibroblast) cells for 3 days. All stromal cultures were stained with monoclonal reagents by indirect immunofluorescence for Class I (beta 2) or Class II (HLA-DR) antigen expression. Supernatant from HSV-stimulated lymphocytes induced HLA-DR antigen on cultured stromal cells while supernatant from lymphocytes cultured in the absence of HSV antigen or from lymphocytes which did not proliferate in response to incubation with HSV antigen did not induce HLA-DR. The expression of Class II antigens induced by supernatant from HSV-stimulated lymphocytes was inhibited by the addition of purified antibodies to IFN.


Observation of Anderson localization in disordered nanophotonic structures.
Anderson localization is an interference effect crucial to the understanding of waves in disordered media. However, localization is expected to become negligible when the features of the disordered structure are much smaller than the wavelength. Here we experimentally demonstrate the localization of light in a disordered dielectric multilayer with an average layer thickness of 15 nanometers, deep into the subwavelength regime. We observe strong disorder-induced reflections that show that the interplay of localization and evanescence can lead to a substantial decrease in transmission, or the opposite feature of enhanced transmission. This deep-subwavelength Anderson localization exhibits extreme sensitivity: Varying the thickness of a single layer by 2 nanometers changes the reflection appreciably. This sensitivity, approaching the atomic scale, holds the promise of extreme subwavelength sensing.


Oral malignant melanoma: long-term follow up in three patients.
Three patients with oral malignant melanoma, who survived for at least ten years after initial examination, are presented. The depth of tumor invasion was 5 mm or less in all patients. The first patient received surgery and postoperative immunotherapy and she had no recurrence more than 18 years after treatment. The second patient underwent surgery but had local recurrence after 11 years. He underwent resection and postoperative chemotherapy and was still alive more than 14 years after initial examination. The third patient received radiotherapy and had metastasis nine months after treatment. Resection and radiotherapy were performed and the patient was alive more than 14 years after first presentation.


Combined gait asymmetry metric.
People with physical impairments often have asymmetric gait. To evaluate if their overall symmetry is improving during intervention, there needs to be a simple metric that can help classify gait patterns that includes multiple measures of gait asymmetry. The Combined Gait Asymmetry Metric presented here is based on the Mahalanobis distance of multiple step parameters. We tested able-bodied subjects with perturbations that involve a change in leg length, the addition of ankle weights, and a combination of both perturbations. The Mahalanobis distances are calculated from perfect symmetry to all points in the data to analyze the effects of the different perturbations. The metric demonstrates how an overall view of symmetry can give a better perspective of asymmetry than only looking at a few individual parameters. This metric is straightforward and can be extended to include large numbers of spatiotemporal, kinematic, and kinetic parameters that more completely evaluate a change in gait symmetry.


A monoclonal antibody to an antigen present on the microvillous membrane of the trophectoderm of the preimplantation blastocyst of the pig.
Immunization of BALB/c mice with 14-day pig preimplantation blastocyst material followed by fusion of spleen cells with NS-0 myeloma cells resulted in a clone, SN 1/38, which secreted IgG1 which reacted specifically with the microvillous border of the pig trophectoderm and trophoblast as assessed by immunohistology. SN 1/38 did not react with other fetal tissues, or with blastocysts from other animal species. It was shown by absorption studies and by enzyme-linked immunoabsorbent assay that SN 1/38 was not directed against the placental form of pig alkaline phosphatase. The location of this antigen and its apparent presence throughout gestation indicate a functional role in the materno-fetal interaction.


Circadian rhythm of serum cortisol in Cushing's disease.
Two women with typical clinical and biochemical features of pituitary-dependent Cushing's disease each underwent hourly blood sampling for 24 h on two separate occasions for measurement of serum cortisol. The 24-h mean serum cortisol concentrations (17.7 and 15.4 micrograms/dl in patient 1; 19.0 and 15.8 micrograms/dl in patient 2) were elevated (normal level, less than 12.5 micrograms/dl), as expected. Cosinor analysis of the patients' serum cortisol patterns revealed statistically significant circadian rhythms on all four profiles. The amplitude of the rhythm on both occasions in patient 1 (5.8 and 6.6 micrograms/dl) and on one of two occasions in patient 2 (7.2 and 10.5 micrograms/dl) fell in the range for the amplitude of the cortisol circadian rhythm in normal subjects (2.2-8.6 micrograms/dl). In contrast to commonly held belief, some patients with Cushing's disease may exhibit circadian variation of serum cortisol.


Atypical choroid plexus papilloma: spontaneous resolution of diffuse leptomeningeal contrast enhancement after primary tumor removal in 2 pediatric cases.
Atypical choroid plexus papillomas can metastasize in the form of leptomeningeal seeding. Postoperative chemotherapy is the recommended first-line treatment when gross-total removal is not achieved or in cases of disseminated disease. Here the authors report on 2 children with atypical choroid plexus papillomas and MRI findings of diffuse leptomeningeal enhancement at diagnosis, later presenting with spontaneous resolution of the leptomeningeal involvement after removal of the primary lesions. Observations in this report expand our knowledge about the natural history and biological behavior of these tumors and highlight the role of close neuroimaging surveillance in the management of atypical choroid plexus papillomas in cases with MRI evidence of diffuse leptomeningeal enhancement at presentation.


[The analysis on influencing factors and its clinical application of cupping spot].
We retrieved and analyzed the articles with the subject term words or key words of the "cupping spot" from January 1, 1990 to May 20, 2018. The negative pressure, cup-retaining time, temperature and the other factors about cupping spot were compared. There was a single stimulus for the negative pressure and cupping time. Pressure and time, pressure and temperature could be considered interactively, and the best group was on research. The color standard of canister spot diagnosis had not been unified, which could be analyzed from its color characteristic and color spectrum. At present, there is no agreement on the measurement of pressure and temperature, selection criteria of subjects, etc. The experimental researchmethods on the spot are becoming more and more diverse, with modern instruments for cupping spot on clinical efficacy and biological mechanism research.


Purinergic Receptor P2Y6 Is a Negative Regulator of NK Cell Maturation and Function.
NK cells are critical innate immune cells that target the tumor cells and cancer-initiating cells and clear viruses by producing cytokines and cytotoxic granules. However, the role of the purinergic receptor P2Y6 in the NK cells remains largely unknown. In this study, we discovered that the expression of P2Y6 was decreased upon the activation of the NK cells. Moreover, in the P2Y6-deficient mice, we found that the deficiency of P2Y6 promoted the development of the NK precursor cells into immature NK and mature NK cells. We also found that the P2Y6 deficiency increased, but the P2Y6 receptor agonist UDP or UDP analog 5-OMe-UDP decreased the production of IFN-γ in the activated NK cells. Furthermore, we demonstrated that the P2Y6-deficient NK cells exhibited stronger cytotoxicity in vitro and antimetastatic effects in vivo. Mechanistically, P2Y6 deletion promoted the expression of T-bet (encoded by Tbx21), with or without the stimulation of IL-15. In the absence of P2Y6, the levels of phospho-serine/threonine kinase and pS6 in the NK cells were significantly increased upon the stimulation of IL-15. Collectively, we demonstrated that the P2Y6 receptor acted as a negative regulator of the NK cell function and inhibited the maturation and antitumor activities of the NK cells. Therefore, inhibition of the P2Y6 receptor increases the antitumor activities of the NK cells, which may aid in the design of innovative strategies to improve NK cell-based cancer therapy.


Clinicopathological study of Rathke's cleft cysts.
The clinical, radiological and pathological characteristics of Rathke's cleft cyst are analyzed and compared with those of ciliated and goblet cell craniopharyngioma (a subset of papillary craniopharyngioma) to clarify the clinicopathological differences between these conditions. We analyzed 42 patients with Rathke's cleft cyst and 3 patients with ciliated and goblet cell craniopharyngioma. Cyst contents and MRI findings of the cyst generally reflected changing pathology of Rathke's cleft cyst. Turbid and less viscous cyst content and heterogeneous T1 and/or T2 signals on MRI sometimes represented predominance of squamous epithelium in the cyst wall. Pathological study disclosed smooth transition from ciliated columnar epithelium typical for Rathke's cleft cyst, via ciliated squamous epithelium, to squamous epithelium typical for craniopharyngioma in the same patients. Ki-67 immunostaining disclosed that the proliferative index of squamous epithelium of Rathke's cleft cyst is significantly higher than that of simple or pseudostratified epithelium of Rathke's cleft cyst (p < 0.05). In conclusion, our extensive study on Rathke's cleft cyst revealed that the high possibility of progression from Rathke's cleft cyst, in which either the cyst content or cyst wall are atypical or squamous epithelium is predominant, compared to ciliated and goblet cell craniopharyngioma and again to papillary craniopharyngioma.


Use of the Intercostal Artery-based Latissimus Dorsi Muscle for Intrathoracic Reconstruction after Division of the Thoracodorsal Vessels and Latissimus Dorsi Muscle.
The latissimus dorsi muscle is the workhorse flap for intrathoracic reconstruction. Prior thoracotomy, which divides the latissimus dorsi muscle, limits the muscle's intrathoracic reach. We present our experience using the distal portion of the muscle for intrathoracic reconstruction based off an intercostal vessel. We also demonstrate the ability of this intercostal perforator to allow for chimeric flap elevation with a separate skin paddle, depending on the branching pattern of the intercostal vessels. This study provides a case series of three consecutive patients, treated between September 2021 and June 2022. The intrathoracic pathology addressed in these patients are bronchopleural fistula, aortoesophageal fistula, and bronchoesophageal fistula. All patients had the resolution of symptoms related to intrathoracic fistulae and did not experience recurrence. This novel pedicled muscle flap can be an additional option for patients with prior thoracotomy and avoids the morbidity which can be seen with the serratus or rectus abdominis muscle flaps.


Detection of Infection with Larval Stages of Ornithobilharzia turkestanicum using PCR in Field-Collected Snails of Lymnaea gedrosiana from Northwestern Iran.
Infection with Ornithobilharzia turkestanicum has been reported in a wide range of animals worldwide. This study was undertaken to assess the utility of polymerase chain reaction (PCR), for detecting the infection with O. turkestanicum larvae stages in Lymnaea gedrosiana. A total of 6,759 Lymnaeidae snails were collected from six aquatic habitats in West Azarbaijan, northwest Iran. Of these, the snails of L. gedrosiana were identified. To detect infected L. gedrosiana with the larval stages of O. turkestanicum, they were subjected for cercarial shedding and molecular examinations. The genomic DNA was extracted and PCR was performed to specifically amplify a fragment of the nuclear 28SrRNA gene of O. turkestanicum. Of all collected snails, 5.4% (365/6,759) were the snails of L. gedrosiana. The cercarial shedding method revealed that 23.56% (86/365) of the snails were infected. The PCR patterns confirmed that 28.77% (105/365) snails of L. gedrosiana were infected with larval stages of O. turkestanicum. The infected snails were observed in five studied sites. The highest infection rate (66.66%, 20/30) was recorded in the snails of Ghargologh in the northern part. Only 35.24% (37/105) of the infected snails were from the plain areas, whereas the remaining existed in high altitudes. It was concluded PCR method could be an efficient and fast method for uncovering the actual rate of infection with larval stages of O. turkestanicum in the snails of L. gedrosiana. This method can be also useful for the domestic animals and public health management programs in the country.


Quality Evaluation and Chemical Markers Screening of Salvia miltiorrhiza Bge. (Danshen) Based on HPLC Fingerprints and HPLC-MSn Coupled with Chemometrics.
Danshen, the dried root of Salvia miltiorrhiza Bge., is a widely used commercially available herbal drug, and unstable quality of different samples is a current issue. This study focused on a comprehensive and systematic method combining fingerprints and chemical identification with chemometrics for discrimination and quality assessment of Danshen samples. Twenty-five samples were analyzed by HPLC-PAD and HPLC-MSn. Forty-nine components were identified and characteristic fragmentation regularities were summarized for further interpretation of bioactive components. Chemometric analysis was employed to differentiate samples and clarify the quality differences of Danshen including hierarchical cluster analysis, principal component analysis, and partial least squares discriminant analysis. Consistent results were that the samples were divided into three categories which reflected the difference in quality of Danshen samples. By analyzing the reasons for sample classification, it was revealed that the processing method had a more obvious impact on sample classification than the geographical origin, it induced the different content of bioactive compounds and finally lead to different qualities. Cryptotanshinone, trijuganone B, and 15,16-dihydrotanshinone I were screened out as markers to distinguish samples by different processing methods. The developed strategy could provide a reference for evaluation and discrimination of other traditional herbal medicines.


MBboard: Validity and Reliability of a New Tool Developed to Evaluate Specific Strength in Rock Climbers.
In the present study, we analysed the validity and reliability of a new tool designed to assist the measurement of maximal upper-limb strength in rock climbers in a specific way, named MBboard. The MBboard consists of an artificial small climbing hold affixed to a wooden board, which is connected to any cable-motion strength equipment to determine the maximum dynamic strength (MBboard-1RM). Ten male rock climbers (Rock Climbing Group, RCG = 10) and ten physically active men (Control Group, CG = 10) performed, on three separate occasions, a familiarization session with procedures adopted during MBboard-1RM testing and two experimental trials (i.e., test and retest) to determine the construct validity and reliability of the MBboard during unilateral seated cable row exercise. In the first trial, the electromyographic activity (EMG) was recorded from the flexor digitorum superficialis. The self-reported climbing ability was also recorded. The RCG had superior performance (i.e. 37.5%) and EMG activity (i.e. 51%) in MBboard-1RM testing when compared with the CG (p < 0.05). There was a significant correlation between the MBboard-1RM results and climbing ability (r > 0.72, p < 0.05). Intraclass correlation coefficient analysis revealed good reliability within trials (ICC > 0.79, p < 0.05). These findings suggest that the MBboard is a valid and reliable tool to assess rock climbing-specific maximal strength. The validity of MBboard-1RM appears to be related to the finger flexor muscles activation, probably reflecting the specific adaptations resulting from long-term practice of this sport discipline.


Proteomic analysis of alpha-1-antitrypsin in immunoglobulin A nephropathy.
Immunoglobulin A nephropathy (IgAN) is recognized as the most common form of primary glomerulonephritis worldwide. It is characterized by mesangial cell proliferation with mesangial IgA deposition in the glomeruli, and is usually associated with secondary tubulointerstitial injury. Although significant progress has been made in the clarification of the pathogenesis of IgAN, the exact pathogenetic mechanism remains unclear. To find out the candidate proteins that play an important role in IgAN, renal cortex tissues and urine from IgAN patients were studied. The 2-DE was performed on renal tissues of IgAN and normal controls. A series of spots identified as alpha-1-antitrypsin (AAT) by mass spectrometry, were found to be significantly increased in patients with IgAN. Up-regulation of AAT variants was validated in renal cortex tissues of IgAN using Western blot and 2-DE immunoblot. Lower isoforms (˜48 kDa) and fragments (˜33 kDa), suspected as cleavage forms by proteinase attack, were especially increased in IgAN compared to normal controls. In addition, AAT proteins modified by tyrosine nitration (approximately 57 and 48 kDa), which reflects excessive oxidative stress, were increased in IgAN tissue. Additionally in the urine of IgAN, increase of AAT variants and fragments was detected by 2-DE immunoblot as well as Western blot. Immunohistochemical staining of IgAN kidney tissue revealed that the increase of AAT appeared to be derived from hypertrophic proximal tubules. The AAT staining in the glomerulus was not clear in IgAN. In addition, immunodepletion-zymography showed a positive correlation between AAT and 80-110-kDa proteinases in IgAN tissue. Further studies regarding the functional roles of AAT and the proteinases will allow better understanding of the pathogenesis of IgAN.


Surgically treated adenocarcinomas of the right side of the colon during a ten year period: a retrospective study.
Colon cancer is one of the most common malignancies in Finland. The purpose of the current study was to analyse the results of surgical treatment of right-sided colon cancers operated in the 1980s at Turku University Central Hospital. In addition, we compared the results to those reported from earlier decades. One hundred and fifty-three patients with primary proximal colon cancer were operated in 1981-1990. The results were analysed retrospectively from patient records. The crude five-year survival rate of the patients was 48%. The most crucial factor affecting survival was the stage of spreading of the tumour. Obstructive tumours had a poorer prognosis than non-obstructive ones. The results of surgical treatment of proximal colon cancer were satisfactory at Turku University Central Hospital and slightly better compared to earlier reports.


Target quit date timing as a predictor of smoking cessation outcomes.
Evidence is mixed on whether timing of a target quit date (TQD) has an effect on quit success. The purpose of this secondary analysis of data from a prospective longitudinal study was to determine if time to TQD was a predictor of smoking abstinence at follow-up. Between 2011 and 2013, a total of 5,793 adult smokers participated in a 1-hr psychoeducation workshop and received 5 weeks of nicotine patch treatment. All participants were required to indicate a TQD within 1 month of the workshop. Latency to TQD was categorized into quartiles: 0 to 1 day (first quartile: 28.1%); 2 to 6 days (second quartile: 22.4%); 7 to 19 days (third quartile: 25.4%); 20-31 days (fourth quartile: 24.0%). Compared with participants who chose an immediate TQD within 1 day of the workshop, odds of having quit smoking at end-of-treatment and 6-month follow-up did not significantly differ among those who set a TQD within 2-6 days (5-weeks: adjusted odds ratio [AOR] = 0.89, p = .315; 6-months: AOR = 0.89, p = .417), but were significantly lower for those who chose a TQD either 7-19 days (5-weeks: AOR = 0.76, p = .023; 6-months: AOR = 0.70, p = .013) or 20-31 days (5-weeks: AOR = 0.64, p = .001; 6-months: AOR = 0.69, p = .017) after the workshop. TQD timing was an independent predictor of smoking cessation outcomes after controlling for potential confounding variables including confidence in quitting ability, importance of quitting, nicotine dependence, and number of nicotine patches used. (PsycINFO Database Record


Efficacy of natural products against Callosobruchus chinensis (Coleoptera: Bruchidae) in Nepal.
This study was conducted to determine the efficacy of local natural products against the beetle, Callosobruchus chinensis L. (Coleoptera: Bruchidae), in stored chickpea Cicer arietinum L. (Fabaceae) in Chitwan, Nepal. Five natural products and one synthetic pesticide (Malathion) and two storage regimes (aluminum sheet bin vs. jute bags with plastic lining) were tested for their effect on stored pulse with respect to damage by C. chinensis. The five natural products included Xanthoylum armatum DC (Rutaceae) fruit powder, Acorus calamus L. (Araceae) rhizome powder, Cinnamom camphora L. (Lauraceae) balls, oil of Sesamum indicum L. (Pedaliaceae), and leaf powder of Azadirachta indica A. Juss. (Meliaceae). Treatments of stored pulses with natural products or with Malathion all caused significantly higher mortality of C. chinensis at 15 d after treatment (DAT) than stored pulses receiving no treatments. The balls of C. camphora, rhizome powder of A. calamus and sesame oil outperformed all other treatments, including the Malathion at 45 and 75 DAT and resulted in significantly reduced damage or deterioration of stored pulses compared with other treatments. Storage regimes performed similarly, although the jute bags did protect seed integrity for some treatments. Our results indicate that incorporating these natural products into stored pulses can protect the seeds from C. chinensis for up to two generations, something that Malathion cannot do. These products are readily available to most farmers in the region and their use will lead to 1) reduction of losses to significant stored product pests, and 2) a reduction of contamination of foodstuffs and the environment by synthetic pesticides like Malathion.


Cardiovascular effects of antidiabetic drugs.
Type 2 diabetes mellitus is a common and severe chronic metabolic disease, which confers increased risk of cardiovascular disease and mortality. During the last decade a large number of new drugs within the classes dipeptidyl peptidase 4 (DPP-4) inhibitors (DPP-4Is), glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1RAs) and sodium/glucose cotransporter 2 (SGLT-2) inhibitors (SGLT-2Is) have been developed and tested in nine large-scale cardiovascular outcome trials (CVOTs). Here we review the evidence behind antihyperglycemic treatment of patients with type 2 diabetes with a particular focus on compiling and summarizing the evidence of hard clinical endpoints stemming from these large CVOTs.


Factitious meningitis. Diagnostic error due to nonviable bacteria in commercial lumbar puncture trays.
A cluster of five false-positive cerebrospinal fluid (CSF) Gram stains led to an investigation of possible causes of specimen or smear contamination. Specimen tubes supplied in commercial lumbar puncture trays from the lot being used in the involved hospital were shown to contain nonviable bacteria, When filled with a test solution and processed in a manner similar to that used for processing CSF specimens, 10 of 12 tubes evaluated yielded Gram stains containing either Gram-negative rods, diplococci, or coccobacilli. Before this problem was recognized, the patient from whom the first false-positive smear was obtained was treated for bacterial meningitis. It is important to realize that microbial contamination of commercial CSF specimen tubes can result in findings simulating those of early bacterial meningitis.


A developmental twin study of symptoms of anxiety and depression: evidence for genetic innovation and attenuation.
Little is known about the pattern of genetic and environmental influences on symptoms of anxiety and depression (SxAnxDep) from childhood to early adulthood.MethodParental- and self-reported levels of SxAnxDep were assessed at ages 8-9, 13-14, 16-17 and 19-20 years in 2508 twins from the Swedish Twin Study of Child and Adolescent Development (TCHAD). Analysis conducted using the Mx program included SxAnxDep by parental and self-report. The best-fit model revealed one genetic risk factor for SxAnxDep acting at ages 8-9, 13-14, 16-17 and 19-20, and new sets of genetic risk factors 'coming on line' in early adolescence, late adolescence and early adulthood. Together, these genetic factors were very strong influences on the levels of SxAnxDep reported in common by parents and twins with heritability estimates, correcting for rater- and time-specific effects, ranging from 72% to 89%. The first genetic factor, which accounted for 72% of the variance in SxAnxDep at ages 8-9, attenuated sharply in influence, accounting for only 12% of the variance by ages 19-20. No evidence was found for shared environmental influences. Although not statistically significant, the correlation between genetic risk factors for SxAnxDep in males and females declined with advancing age. Genetic effects on SxAnxDep are developmentally dynamic from middle childhood to young adulthood, demonstrating both genetic innovation and genetic attenuation. The attenuation might explain the low levels of continuity observed for anxiety and depressive disorders from childhood to adulthood. Differences in genetic risk factors for SxAnxDep in males and females may increase during development.


Management of a tracheal intussusception in a dog.
A 5-year-old Belgian Malinois dog was presented for evaluation of dyspnea of 1-month duration. Tracheal intussusception was diagnosed by tracheoscopy. Treatment consisted of surgical resection of the invaginated tracheal ring and the immediate cranial and caudal tracheal rings. The dog recovered uneventfully; complications included temporary emphysema after surgery. Seven months after surgery, the dog was still clinically normal. To the authors' knowledge, this is the first report of a tracheal intussusception treated surgically in a dog.


Neuropathogenesis of simian immunodeficiency virus infection in macaque monkeys.
Patients infected with human immunodeficiency virus (HIV) develop immunologic dysfunction and multiorgan inflammatory diseases directly associated with HIV-1 infection. Of these inflammatory diseases, the most devastating to the HIV-infected patient is involvement of the central nervous system (CNS). The pathogenesis of the clinical syndrome observed in these patients, termed HIV-associated dementia, remains poorly understood. However, as most of the detectable virus in the CNS is in cells of monocyte/macrophage lineage, it is clear that penetration of the blood-brain barrier by HIV-1 and the subsequent influx of monocytes into the brain are crucial components in the neuropathogenesis of HIV-associated dementia. Using the SIV-infected macaque model of acquired immunodeficiency disease, much has been learned about viral neuroinvasion occurring soon after experimental infection. The aim of this review is to discuss these recent advances and provide insight into plausible mechanisms for monocyte entry into the CNS.


Small-cell carcinoma of the esophagus: a case treated by chemotherapy.
A patient with small-cell carcinoma of the esophagus treated with cyclophosphamide and vincristine is described. Within 2 months after the beginning of therapy, two coexisting tumors had disappeared and the main primary lesion and metastases in the liver and lymph nodes were markedly reduced in size. The patient relapsed 5 months after the start of therapy and died with widespread metastases. Autopsy revealed that the patient was in partial remission.


Insulin Pump Combined with Flash Glucose Monitoring: A Therapeutic Option to Improve Glycemic Control in Severely Nonadherent Patients with Type 1 Diabetes.
Some patients with type 1 diabetes (T1D) are severely noncompliant; they rarely perform self-blood glucose measures and miss insulin injections. Their HbA1c is far above the target rate. Current guidelines do not recommend starting treatment with an insulin pump (continuous subcutaneous insulin infusion [CSII]) for these persons. The aim of this study was to determine whether a CSII associated with a flash glucose monitoring (FGM) device could reduce HbA1c without increasing the risk of acute events, diabetic ketoacidosis (DKA) and severe hypoglycemia (SH), in these patients. We conducted a 6-month nonrandomized, pilot prospective study. Patients with T1D on multiple daily injections who performed less than two self-blood glucose tests/day and had an HbA1c >9% were equipped with CSII and an FGM device. The primary composite endpoint was defined by a change in HbA1c ≥1% without any episode of DKA or SH during 6 months. Change in mean HbA1c, weight, treatment satisfaction, frequency of minor hypoglycemia, and ketoacidosis were secondary endpoints. Nineteen adults were included. Median (Q1-Q3) HbA1c at baseline was 10.8 (10.3-13.0), 14 participants did not perform any self-monitoring and 5 performed maximum two tests daily. Twelve participants (63%) (95% confidence interval 41%-81%) met the primary composite endpoint. Seventeen patients completed the study. HbA1c decreased by 2% (1.0-3.3) (P < 0.001), and satisfaction with treatment significantly improved. Three participants experienced SH and one a DKA, versus, respectively, five and eight in the year preceding the study. Participants scanned the sensor 4 (3-6) times per day and injected 3 (2.7-4.1) boluses per day. Weight increased significantly. An association of an insulin pump with an FGM device can be an effective and safe therapeutic option in severely nonadherent and noncompliant patients with high HbA1c.


Verrucostoma, a new genus in the bionectriaceae from the Bonin Islands, Japan.
Verrucostoma freycinetiae gen. et sp. nov. is described and illustrated from specimens on dead leaves of Freycinetia boninensis (Pandanaceae) collected in Hahajima, Bonin (Ogasawara) Islands, Japan. The genus is characterized by pale orange perithecia with protuberances around the perithecial apex, no color change in 3% potassium hydroxide and lactic acid, unitunicate asci, spinulose ascospores and an Acremonium-like anamorph. Morphological characters were compared with other genera in the Bionectriaceae and Nectriaceae (Hypocreales). Verrucostoma is morphologically similar to Bionectria (Bionectriaceae) from which it differs in the formation of conspicuous protuberances around the perithecial apex and the Acremonium-like anamorph. Moreover molecular analyses of Verrucostoma and other members of the Bionectriaceae and Nectriaceae based on alpha-actin, large subunit nuclear ribosomal DNA and RNA polymerase II subunit 1 sequences support the conclusions based on morphological data. Our results confirm that V. freycinetiae is distinct from other genera among the Nectria-like fungi and represents a new genus belonging to the Bionectriaceae.


Regulation of photochemical energy transfer accompanied by structural changes in thylakoid membranes of heat-stressed wheat.
Photosystems of higher plants alleviate heat-induced damage in the presence of light under moderate stressed conditions; however, in the absence of light (i.e., in the dark), the same plants are damaged more easily. (Yamauchi and Kimura, 2011) We demonstrate that regulating photochemical energy transfer in heat-treated wheat at 40 °C with light contributed to heat tolerance of the photosystem. Chlorophyll fluorescence analysis using heat-stressed wheat seedlings in light showed increased non-photochemical quenching (NPQ) of chlorophyll fluorescence, which was due to thermal dissipation that was increased by state 1 to state 2 transition. Transmission electron microscopy revealed structural changes in thylakoid membranes, including unstacking of grana regions under heat stress in light. It was accompanied by the phosphorylation of thylakoid proteins such as D1 and D2 proteins and the light harvesting complex II proteins Lhcb1 and Lhcb2. These results suggest that heat stress at 40 °C in light induces state 1 to state 2 transition for the preferential excitation of photosystem I (PSI) by phosphorylating thylakoid proteins more strongly. Structural changes of thylakoid membrane also assist the remodeling of photosystems and regulation of energy distribution by transition toward state 2 probably contributes to plastoquione oxidation; thus, light-driven electrons flowing through PSI play a protective role against PSII damage under heat stress.


A Novel STK4 Mutation Impairs T Cell Immunity Through Dysregulation of Cytokine-Induced Adhesion and Chemotaxis Genes.
Human serine/threonine kinase 4 (STK4) deficiency is a rare, autosomal recessive genetic disorder leading to combined immunodeficiency; however, the extent to which immune signaling and host defense are impaired is unclear. We assessed the functional consequences of a novel, homozygous nonsense STK4 mutation (NM_006282.2:c.871C > T, p.Arg291*) identified in a pediatric patient by comparing his innate and adaptive cell-mediated and humoral immune responses with those of three heterozygous relatives and unrelated controls. The genetic etiology was verified by whole genome and Sanger sequencing. STK4 gene and protein expression was measured by quantitative RT-PCR and immunoblotting, respectively. Cellular abnormalities were assessed by high-throughput RT-RCR, RNA-Seq, ELISA, and flow cytometry. Antibody responses were assessed by ELISA and phage immunoprecipitation-sequencing. The patient exhibited partial loss of STK4 expression and complete loss of STK4 function combined with recurrent viral and bacterial infections, notably persistent Epstein-Barr virus viremia and pulmonary tuberculosis. Cellular and molecular analyses revealed abnormal fractions of T cell subsets, plasmacytoid dendritic cells, and NK cells. The transcriptional responses of the patient's whole blood and PBMC samples indicated dysregulated interferon signaling, impaired T cell immunity, and increased T cell apoptosis as well as impaired regulation of cytokine-induced adhesion and leukocyte chemotaxis genes. Nonetheless, the patient had detectable vaccine-specific antibodies and IgG responses to various pathogens, consistent with a normal CD19 + B cell fraction, albeit with a distinctive antibody repertoire, largely driven by herpes virus antigens. Patients with STK4 deficiency can exhibit broad impairment of immune function extending beyond lymphoid cells.


Histopathological changes in root and stem of mungbean exposed to Macrophomina phaseolina and dry biomass of Chenopodium quinoa.
Mungbean production is affected by a fungal pathogen Macrophomina phaseolina. A pot experiment was carried out to check the effect of quinoa (Chenopodium quinoa Willd.) dry biomass on the histopathological features of mungbean exposed to M. phaseolina. For this, 1%, 2% and 3% (wt/wt) of C. quinoa dry biomass was mixed in the soil inoculated with M. phaseolina. The highest disease incidence (36%) was recorded in the positive control (only M. phaseolina). Different treatments of quinoa dry mass reduced disease incidence to 4-7%. After 4 weeks of germination, stem and root sections were stained in phloroglucinol-HCl, ferric chloride and Lugol's iodine stains for the detection of lignin, polyphenols and starch granules, respectively, and studied under light microscope. Plants of positive control showed damaged cells, and heavy deposition of lignin, phenolics and starch granules as compared to plants of the negative control and those grown in the soil amended with different doses of dry biomass of quinoa. For better understanding, plant root and stem sections were studied under a scanning electron microscope. Plant sections from positive control exhibited the presence of M. phaseolina sclerotial bodies and hyphal growth, whereas in negative control normal cell structures were observed. However, C. quinoa amended stem and root sections revealed the presence of high gel deposition with normal cell structures and no pathogen establishment. This study concludes that application of C. quinoa is an effective and natural remedy to activate the resistance mechanism in plants and to combat the adverse effects of M. phaseolina. HIGHLIGHTS: Macrophomina phaseolina causes charcoal rot in mungbean. Chenopodium quinoa amendment significantly reduced incidence of charcoal rot disease. M. phaeolina increased concentrations of polyphenols, lignin and starch granules in mungbean.


Cytochrome in Thiobacillus thiooxidans.
Cytochrome is present in the autotrophic sulfur bacterium, Thiobacillus thiooxidans. As mediator in the final electron transfer to oxygen, the cytochrome participates in the oxidation of sulfur compounds by extracts of the organism.


Increasing patient satisfaction with natural denture teeth.
Successful laboratory communication in removable prosthodontics will always be more complex than in fixed prosthodontics. However, the unique characteristics of natural denture teeth (SR-Antaris/SR-Postaris), Ivoclar Williams, Amherst, NY) are enabling clinicians to overcome functional and aesthetic challenges. Specifically, the characterized anatomy of these anterior and posterior teeth, and their translucency and natural layering, facilitate the reestablishment of a natural smile. This article describes the benefits of SR-Antaris/SR-Postaris denture teeth and provides guidelines for communication with the laboratory to ensure predictable results.


From the profane to the sacred: why we need to retrieve Christian bioethics.
Christianity has been crucial in the conceptualization and articulation of the moral framework of the Western tradition. The social sciences, including ethics, were modeled on physical science. However, the Enlightenment project inculcated a metaphysics and an epistemology that reduced the subject to an object and thus undermined the conditions of freedom, agency and an accessible cosmic order; all of which are essential to morality. Competing value claims were shunted into a political context for resolution, but the politicalized morality itself requires a framework for evaluating resolutions. While neither the Enlightenment nor post-modernism can provide such a framework, Christian tradition can, in fact, provide just such a framework and response.


Iron Oxide Nanoradiomaterials: Combining Nanoscale Properties with Radioisotopes for Enhanced Molecular Imaging.
The combination of the size-dependent properties of nanomaterials with radioisotopes is emerging as a novel tool for molecular imaging. There are numerous examples already showing how the controlled synthesis of nanoparticles and the incorporation of a radioisotope in the nanostructure offer new features beyond the simple addition of different components. Among the different nanomaterials, iron oxide-based nanoparticles are the most used in imaging because of their versatility. In this review, we will study the different radioisotopes for biomedical imaging, how to incorporate them within the nanoparticles, and what applications they can be used for. Our focus is directed towards what is new in this field, what the nanoparticles can offer to the field of nuclear imaging, and the radioisotopes hybridized with nanomaterials for use in molecular imaging.


The diagnostic imaging of bone metastases.
Skeletal metastases are the most common malignant tumor in bone. Certain types of cancer (e.g., of the prostate or breast) are particularly likely to give rise to skeletal metastases, with prevalences of up to 70%. The diagnosis of skeletal metastases has a major impact on the overall treatment strategy and is an important determinant of the course of illness and the quality of life. The goal of diagnostic imaging is to detect skeletal metastases early, whenever they are suspected on the basis of clinical or laboratory findings or in patients who are at high risk. Other important issues include assessment of the risk of fracture and the response to treatment. This review is based on selected pertinent articles published up to December 2013. Projectional radiography (plain films) is still useful for the immediate investigation of symptomatic bone pain and for the assessment of stability. Skeletal scintigraphy, the classic screening test for patients with cancer who do not have bone pain (specificity 81%, sensitivity 86%), has now been supplemented-in some cases, replaced-by other techniques. CT, including lowdose CT, is used to detect changes in bone structure due to metastases of some types of primary tumor (specificity 95%, sensitivity 73%); whole-body MRI, to detect metastases in the bone marrow and extraosseous soft tissues, e.g., metastases compressing the spinal cord (specificity 95%, sensitivity 91%); PET-CT, to detect metabolically active tumors (specificity 97%, sensitivity 90%). Different imaging modalities are often used in combination to detect bone metastases optimally. Owing to advances in modern tomographic imaging, the current trend is toward whole-body imaging in a single session. The choice of method is based on the clinical situation and the type of primary tumor. Further research should address the impact of these costly and laborintensive imaging methods on treatment strategies and on the course of illness.


Vapor-liquid phase behavior of a size-asymmetric model of ionic fluids confined in a disordered matrix: The collective-variables-based approach.
We develop a theory based on the method of collective variables to study the vapor-liquid equilibrium of asymmetric ionic fluids confined in a disordered porous matrix. The approach allows us to formulate the perturbation theory using an extension of the scaled particle theory for a description of a reference system presented as a two-component hard-sphere fluid confined in a hard-sphere matrix. Treating an ionic fluid as a size- and charge-asymmetric primitive model (PM) we derive an explicit expression for the relevant chemical potential of a confined ionic system which takes into account the third-order correlations between ions. Using this expression, the phase diagrams for a size-asymmetric PM are calculated for different matrix porosities as well as for different sizes of matrix and fluid particles. It is observed that general trends of the coexistence curves with the matrix porosity are similar to those of simple fluids under disordered confinement, i.e., the coexistence region gets narrower with a decrease of porosity and, simultaneously, the reduced critical temperature T_{c}^{*} and the critical density ρ_{i,c}^{*} become lower. At the same time, our results suggest that an increase in size asymmetry of oppositely charged ions considerably affects the vapor-liquid diagrams leading to a faster decrease of T_{c}^{*} and ρ_{i,c}^{*} and even to a disappearance of the phase transition, especially for the case of small matrix particles.


Canine behaviour problems: discussions between veterinarians and dog owners during annual booster consultations.
The veterinary profession recently acknowledged its responsibility to provide behaviour support, following criticism for focussing on the physiological aspects of welfare and overlooking the psychological. To further understand the practising of behavioural medicine, a 'fly-on-the-wall' approach was used to investigate welfare discussions during dog booster vaccinations. Seventeen consultations involving six veterinarians in two UK small-animal practices were videoed. Qualitative methods were used to analyse themes discussed and questionnaires completed to obtain participant information and perceptions. Five main topics of discussion were identified: navigation, medical, husbandry, behaviour and cost. Veterinarians led the discussion of all topics except behaviour which was instigated approximately equally by veterinarian and client. All clients reported one or more behaviours that were a concern to them, totalling 58 across the sample. Disconcertingly, only 10 were discussed during consultations and none fully explored nor managed beyond the consultation. Behaviour discussion varies between veterinarians; this may reflect their experience, confidence or clients' requests. Owners access welfare information from a variety of sources, not always from veterinarians. Where sources are not knowledgeable, both human and animal welfare can be seriously compromised. Veterinarians need to ensure that clients are enabled to discuss behaviour issues and are provided with appropriate support, be that in-house or via referral.


Expounding the rehabilitation service for acquired visual impairment contingent on assistive technology acceptance.
Globally, approximately 285 million people have visual impairments, with over 39 million people having full blindness. Beginning in the late nineteenth century, assistive devices such as service dogs, braille reading devices, and white canes have aided those with visual impairments. From the immense development of technology over the past two decades, traditional assistive devices have been supplemented with more technologically innovative assistive technologies. Despite this technological growth, many people with visual impairments have chosen to forgo the use of assistive technologies and continue to use traditional assistive devices instead. We have devised a series of surveys and questionnaires to study the views of those with visual impairments towards assistive technologies. Our survey was given to 568 visually impaired people in Taiwan both in person and electronically; the data was cross-referenced with the demographic information of the surveyors to find the disparities in user-preferences amongst different levels of visual impairment, age, household income, and other demographic factors. Results drawn from the data concluded that while there was a large variation in whether or not participants used assistive technology, those that did indicated that assistive technologies were purchased to help them live life more independently. While assistive technology provides a beacon of hope for the visually impaired to live more independent lives, the data indicated that many visually impaired people were not aware of the new assistive technologies and devices that have been entering the market; furthermore, many visually impaired people are of lower income, and therefore cannot afford the technology.Implications for rehabilitationDetermining differences between congenital and acquired visual impairments, and comparing how the two types of visually impaired users have preferences over the assistive technology and devices that they utilise.Experience of life without visual impairment disincentivizes visually impaired people from purchasing new assistive technologies, whereas the appeal of an independent lifestyle incentivizes it.The visually impaired tend to purchase assistive technologies to operate rehabilitation more effectively, and the use of assistive technology and assistive devices, respectively, encourage future participation in rehabilitation.Marketability and cost of assistive technologies are the largest deterrents from visually impaired users from buying new technologies.


Field-theoretic analysis of directed percolation: Three-loop approximation.
The directed bond percolation is a paradigmatic model in nonequilibrium statistical physics. It captures essential physical information on the nature of continuous phase transition between active and absorbing states. In this paper, we study this model by means of the field-theoretic formulation with a subsequent renormalization group analysis. We calculate all critical exponents needed for the quantitative description of the corresponding universality class to the third order in perturbation theory. Using dimensional regularization with minimal subtraction scheme, we carry out perturbative calculations in a formally small parameter ɛ, where ɛ=4-d is a deviation from the upper critical dimension d_{c}=4. We use a nontrivial combination of analytical and numerical tools in order to determine ultraviolet divergent parts of Feynman diagrams.


ATBS1 INTERACTING FACTORs negatively regulate Arabidopsis cell elongation in the triantagonistic bHLH system.
We recently demonstrated that cell elongation in plants is regulated by a triantagonistic bHLH system, in which three bHLH proteins, Activator of Cell Elongation 1 (ACE1), Arabidopsis ILI1 binding BHLH 1 (AtIBH1) and Paclobutrazol Resistance 1 (PRE1), competitively regulate the expression of genes for cell elongation. Here we show that ATBS1 Interacting Factor 2 (AIF2), AIF3 and AIF4 interact with PRE1 and ACE1, similar to AtIBH1, and also negatively regulate cell elongation in the triantagonistic bHLH system. The expression of each AIF is constitutive or induced by light, but AtIBH1 expression is dependent on BR signaling and developmental phase. These results indicate that AIFs and AtIBH1 may play different roles in cell elongation in different signaling pathways.


Laparoscopic gastric plication for the treatment of morbid obesity: a review.
Introduction. Laparoscopic greater curvature plication is an operation that is gaining ground in the treatment of morbid obesity, as it appears to replicate the results of laparoscopic sleeve gastrectomy with fewer complications. Aim. Review of current literature, especially results on weight loss and complications. Method. 11 (eleven) published articles on laparoscopic gastric plication, of which 1 preclinical study, 8 prospective studies for a total of 521 patients and 2 case reports of unusual complications. Results. Reported Paracentage of EWL in all studies is comparable to Laparoscopic Sleeve Gastrectomy (around 50% in 6 months, 60-65% in 12 months, 60-65% in 24 months) and total complication rate is at 15,1% with minor complications in 10,7%, major complications in 4,4%. Reoperation rate was 3%, conversion rate was 0,2%, and mortality was zero. Conclusion. Current literature on gastric plication and its modifications is limited and sketchy at times. Low cost, short hospital stay, absence of prosthetic material, and reversibility make it an attractive option. Initial data show that LGCP is effective for short- and medium-term weight loss, complication and reoperation rates are low, and GERD symptoms are unaffected. More data is required, and randomized control trials must be completed in order to reach safe conclusions.


Distribution of postsynaptic GABA(A) receptor aggregates in the deep cerebellar nuclei of normal and mutant mice.
In the central nervous system, the aggregation of receptors is crucial for synapse formation and function. To study the role of presynaptic terminals in the maintenance of postsynaptic specializations, we analyzed the synaptic contacts between Purkinje cells and neurons of the deep cerebellar nuclei in two in vivo models: the Lurcher and Purkinje cell-deficient (PCD) mutant mice. These mutants lose their Purkinje cells at different postnatal stages. By using confocal scanner microscopy and immunohistochemistry, we studied the distribution of the alpha subunit of the gamma-aminobutyric acid (GABA)(A) receptor (GABA(A)Ralpha1) and gephyrin, one of its anchoring proteins, in relation to the distribution of presynaptic markers, glutamic acid decarboxylase (GAD), or synaptophysin. In Lurcher the distribution of GABA(A) receptor aggregates on the membrane of postsynaptic neurons was not affected by the important loss of GAD-positive terminals, whereas in PCD, the number of large GABA(A) receptor aggregates increased. In both mutants the number of aggregates of gephyrin decreased. Most of these remaining aggregates were clustered to form groups, some of which were in front of GAD-positive terminals. This study shows, for the first time, the localization of GABA(A)R alpha 1 in Lurcher and PCD mutant mice. It clearly establishes that GABA(A)R alpha 1 and gephyrin are differentially affected by deafferentation. Because the receptor aggregates are maintained while the gephyrin aggregates are lost, as a result some receptor aggregates are not associated with any gephyrin. These two postsynaptic components appeared to be regulated by different mechanisms.


Phylogenetic and network analysis of Pediculus humanus in Nigeria reveal the presences of clade E body lice and novel haplotypes.
An investigation was conducted for the first time to determine the prevalence and genetic diversity of human lice, for the first time in Nigeria, using conventional PCR and sequencing methods. Three mitochondrial genes, cytochrome oxidase subunit 1 (cox1), cytochrome b (cytb), and 12S rRNA of Nigerian human lice, were amplified, sequenced, and analyzed. Overall, high prevalence (72.5%; 103/142) of lice infestation was recorded among the examined volunteers. Head lice infestation was more common 63 (61.2%) than body lice infestation 34 (33.0%). Co-infestation with both head and body lice was recorded in six humans (5.8%). The Nigerian human lice specimens were placed mostly into clade A with few in clade E, including body lice for the first time. Six, three, and eight haplotypes of Nigerian human lice were obtained for the cytb, cox1, and 12S rRNA genes, respectively. Additionally, one (E51), three (A31, A32, and E5), and six (A20, A21, A23, A24, A30, and E1) novel haplotypes were recorded for cox1, cytb, and 12S rRNA, respectively, from the Nigerian specimens which were corroborated by the ML phylogenetic trees and MJ network analyses. Genetic diversity indices indicate minimal variation in the parameters analyzed among the clades of the three genes. However, a statistically significant Snn test, negative Tajima's D test for clade A (cox1 and 12S rRNA genes), and negative Fu and Li's D test in clade A for cox1 gene indicate a geographical structure and the signature of population expansion of the Nigerian human lice. The findings from this study provide additional data on the human lice structure in Africa.


"Becoming a mother'--developing a new theory of early motherhood.
This paper explains the methods used in a grounded theory analysis of the experience of 55 first-time mothers in Australia, presented in the first of this series of two papers. The categories identified in the research are realising, readiness, drained, aloneness, loss and working it out, encompassed in the core category becoming a mother. Specifically, this paper extends the analysis and explains the application of a 'paradigm model' and the identification of a Basic Social Process (BSP). The paper links the analysis to the literature on early motherhood from nursing, midwifery, feminist, and sociological research. A substantive theory is proposed to explain women's experience in becoming mothers that demonstrates how, when responsive to the needs of those researched, a grounded theory analysis can provide a framework for nursing and midwifery care.


Suspected myocardial infarction in the emergency department: An evaluation of clinical thresholds for the Beckman Coulter Access hsTnI high-sensitivity cardiac troponin I assay.
The primary objective was to determine rapid rule-out (RRO) criteria for the outcome of myocardial infarction (MI) using the Beckman Coulter Access high-sensitivity cardiac troponin I (hs-cTnI) assay. Secondary objectives were to explore cut-points for rapid rule-in (RRI) and amount of change at 3-h (3-h delta) indicative of MI. A retrospective study included ED patients with suspected MI between June and September 2019. hs-cTnI levels were performed at baseline and after 3 h. The performance benchmark for RRO criteria was a negative predictive value (NPV) for MI with a lower 95% confidence limit >99%, and for RRI and 3-h delta cut-points was a positive predictive value (PPV) for MI >70%. Delta calculation required rising hs-cTnI levels, with at least one above the 99th percentile of the upper reference limit. Analyses utilised receiver operating characteristic (ROC) curves and contingency tables. Baseline hs-cTnI levels from 935 patients were available for RRO analyses. Of tested criteria, baseline hs-cTnI <6 ng/L (females) or <11 ng/L (males) plus symptom onset >2 h met the performance benchmark (NPV: 100% [95% confidence interval 99-100]). hs-cTnI levels were available for RRI and 3-h delta analyses from 935 and 52 patients, respectively. A 3-h delta cut-point >35 ng/L met the performance benchmark (PPV: 81% [95% confidence interval 58-95]) but no RRI cut-point did so. For the Beckman Coulter Access hs-cTnI assay, RRO criteria of baseline hs-cTnI <6 ng/L (females) or <11 ng/L (males) plus symptom onset >2 h met our performance benchmark. A 3-h delta cut-point >35 ng/L met the performance benchmark, but poor precision means further adequately powered research is required.


Identification of novel short chain 4-substituted indoles as potent alphavbeta3 antagonist using structure-based drug design.
The vitronectin receptor alpha(v)beta(3) has been identified as a promising potential target for the treatment of osteoporosis, diabetic retinopathy and cancer. We have recently reported 5-substituted indoles 3-[5-[2-(5,6,7,8-tetrahydro[1,8]naphthyridin-2-yl)ethoxy]indol-1-yl]-3-(3-pyridyl)propionic acid 3 and 3-[5-[2-(5,6,7,8-tetrahydro[1,8]naphthyridin-2-yl)ethoxy]indol-1-yl]-3-(3,4-methylenedioxyphenyl)propionic acid 4, as an original series of potent alpha(v)beta(3) antagonists with subnanomolar activity. Ligand-protein docking analyses have been performed to generate binding models of three different chemical classes of known alpha(v)beta(3) antagonists with alpha(v)beta(3). Results of this docking study suggested that indoles bearing the basic tetrahydronaphthyridine group at position 4 can easily adopt the correct binding conformation and should be as potent as our current 5-substituted indole leads 3 and 4. This hypothesis was nicely demonstrated by the synthesis of a series of 1,4-disubstituted indoles through a tandem of reactions involving: (i) the N-alkylation of indoles 15 and 22 with propargyl esters and cesium fluoride, and (ii) a Heck coupling reaction between 4-bromoindole and 7-vinyl-3,4-dihydro-2H-[1,8]naphthyridine-1-carboxylic acid tert-butyl ester 12, or (iii) a reductive amination involving the N-substituted-4-aminoindole 23 and the BOC-protected tetrahydro[1,8]naphthyridine aldehyde 13. Among the compounds assayed, 3-(3-pyridyl)-3-[4-[2-(5,6,7,8-tetrahydro[1,8]naphthyridin-2-yl)ethyl]indol-1-yl]propionic acid 21 showed the most promising activity on alpha(v)beta(3) (IC(50)=0.5 nM), and was found to have the same potency as our current leads 3 and 4, while maintaining selectivity over alpha(IIb)beta(IIIa). Moreover, based on the reasonable apparent permeability coefficient in an in vitro CACO-2 cell monolayer assay (P(app) apical/basolateral=2.2 x 10(-6)cm/s, P(app) basolateral/apical=2.5 x 10(-6)cm/s), compound 21 is expected to be absorbed through the intestine in human. Thus, 1,4-disubstituted indole 21 represents a new lead for this novel class of conformationally restricted alpha(v)beta(3) antagonists. Additionally, this study validates the pharmacophore model previously postulated and provides an improved basis for further structure-based drug design in the field of alpha(v)beta(3).


The Role of Medication Beliefs in COVID-19 Vaccine and Booster Uptake in Healthcare Workers: An Exploratory Study.
Illness and medication beliefs have shown to predict COVID-19 vaccination behaviour in the general population, but this relationship has yet to be demonstrated in healthcare staff. This research aimed to explore the potential explanatory value of illness and medication beliefs on the COVID-19 vaccination uptake of a sample of patient-facing healthcare workers (HCWs). A web-based questionnaire-measuring beliefs about vaccinations (the BMQ), perceptions of COVID-19 (the BIPQ), vaccine hesitancy, and vaccine uptake-was targeted to HCWs via social media platforms between May-July 2022. Open text responses allowed participants to provide explanations for any delay in vaccine uptake. A total of 91 participants completed the questionnaire. Most respondents (77.1%, n = 64) had received three doses of the COVID-19 vaccination, and vaccination uptake (number of doses received) was predicted by Vaccine Concerns, Vaccine Hesitancy, and their Necessity-Concerns Differential score. Vaccine Hesitancy was predicted by Necessity, Concerns, and Overuse scores, as well as Necessity-Concerns Differential scores. Delay in Vaccine Uptake could only be predicted for Dose 3 (Booster). Qualitative data revealed that hesitant respondents were "unable to take time off work" for vaccination and that some had concerns over vaccine safety. In conclusion, illness and medication beliefs have potential value in predicting vaccine hesitancy and uptake in healthcare workers. Interventions to improve vaccination uptake in this population should address concerns about vaccine safety and releasing staff for vaccination booster appointments should be prioritised. Future research should further investigate the relationship between illness and medication beliefs and COVID-19 vaccine uptake in a larger sample of healthcare workers.


Conformational heterogeneity of surface-grafted amyloidogenic fragments of alpha-synuclein dimers detected by atomic force microscopy.
A force-spectroscopy-based approach is used to characterize separation between amyloidogenic peptide fragments of alpha-synuclein. Interactions between individual molecules are studied using a scanning-force-microscopy-based technique. Alpha-synuclein fragments are attached to the solid surfaces via flexible long poly-(ethylene glycol) linkers removing aggregation state uncertainty of solution-based approaches and spurious surface effects. Tethering one fragment to the scanning probe tip and another fragment to the second surface ensures that interactions between tethered molecules are studied. Control experiments with only one tethered peptide indicate peptide-peptide interactions as the source of observed interaction forces in the double-tether experiment. The temperature dependence of rupture forces from 17.5 degrees C to 40 degrees C reveals similar molecular parameters indicating that no significant conformational changes occur in the associated molecules over this temperature range. Rate-dependent measurements indicate conformational heterogeneity of joined peptide molecules.


Mother's education and the risk of several neonatal outcomes: an evidence from an Italian population-based study.
Maternal socioeconomic disparities strongly affect child health, particularly in low and middle income countries. We assessed whether neonatal outcomes varied by maternal education in a setting where healthcare system provides universal coverage of health services to all women, irrespective of their socioeconomic status. A population-based study was performed on 383,103 singleton live births occurring from 2005 to 2010 in Lombardy, an Italian region with approximately 10 million inhabitants. The association between maternal education, birthplace and selected neonatal outcomes (preterm birth, low birth weight, small-for-gestational age, low 5-min Apgar score, severe congenital anomalies, cerebral distress and respiratory distress) was estimated by fitting logistic regression models. Model adjustments were applied for sociodemographic, reproductive and medical maternal traits. Compared with low-level educated mothers, those with high education had reduced odds of preterm birth (Odds Ratio; OR = 0.81, 95% CI 0.77-0.85), low birth weight (OR = 0.78, 95% CI 0.70-0.81), small for gestational age (OR = 0.82, 95% CI 0.79-0.85), and respiratory distress (OR = 0.84, 95% CI 0.80-0.88). Mothers born in a foreign country had higher odds of preterm birth (OR = 1.16, 95% CI 1.11-1.20), low Apgar score (OR = 1.18, 95% CI 1.07-1.30) and respiratory distress (OR = 1.19, 95% CI 1.15-1.24) than Italian-born mothers. The influence of maternal education on neonatal outcomes was confirmed among both, Italian-born and foreign-born mothers. Low levels of education and maternal birthplace are important factors associated with adverse neonatal outcomes in Italy. Future studies are encouraged to investigate factors mediating the effects of socioeconomic inequality for identifying the main target groups for interventions.


'We need a safe, walkable way to connect our sisters and brothers': a qualitative study of opportunities and challenges for neighborhood-based physical activity among residents of low-income African-American communities.
The purpose of this study was to explore perceptions of the benefits of and influencing factors for neighborhood-based physical activity (PA), and elicit suggestions for increasing neighborhood-based PA among primarily Black residents living in lower income neighborhoods. Eight focus groups were conducted in low-income, predominantly Black neighborhoods (n = 8) in Greenville, SC during Spring 2014. Using a semi-structured focus group guide with open-ended questions, residents were asked to describe benefits of PA, neighborhood factors associated with PA, and ways to increase PA within their neighborhoods. Trained research assistants transcribed audio recordings verbatim. Using grounded theory and an ecological perspective, emergent coding was employed to generate initial categories with open and axial coding used to achieve consensus on themes. Primarily Black (95%), female (72%), and older (M = 61.5 years) residents (N = 76) participated in the study. Seven themes were identified across the three main focus group topics: physical and mental health benefits of neighborhood PA, safety/hazards and social factors as influencing neighborhood PA, and improving safety, structural opportunities, and programing support to improve neighborhood PA. Most participants reported walking within their communities, despite describing several community-level barriers (e.g. drugs, safety). Residents desired structured neighborhood-based opportunities for increasing PA, including walking tracks and walking groups, and reported social benefits to being active, including increased awareness within the community and trust. Participants conveyed that walking strengthened the social environment of their community as well as the health of residents. Few studies of contextual factors and PA have focused on African-American, low-income neighborhoods. Despite diverse environmental constraints, residents reported walking within their communities as part of a healthy lifestyle. Social ecological interventions tailored to promote PA and reduce health disparities among residents of low-income communities should highlight neighborhood-based opportunities for PA, focusing on personal and collective social benefits of neighborhood walking.


[Bilateral aplasia of the proximal part of fibula (author's transl)].
Report of an infant with aplasia of the proximal part of the fibula on both sides; by our knowledge the second observation in the literature. Furthermore the infant shows an aplasia of the thyroidea, a coarctation of the aorta, an atrial septal defect and an intraperitoneally situated ascending as well as descending colon.


Whole Genome Sequencing of the Blue Tilapia (Oreochromis aureus) Provides a Valuable Genetic Resource for Biomedical Research on Tilapias.
Blue tilapia (Oreochromis aureus) has been an economically important fish in Asian countries. It can grow and reproduce in both freshwater and brackish water conditions, whereas it is also considered as a significant invasive species around the world. This species has been widely used as the hybridization parent(s) for tilapia breeding with a major aim to produce novel strains. However, available genomic resources are still limited for this important tilapia species. Here, we for the first time sequenced and assembled a draft genome for a seawater cultured blue tilapia (0.92 Gb), with 97.8% completeness and a scaffold N50 of 1.1 Mb, which suggests a relatively high quality of this genome assembly. We also predicted 23,117 protein-coding genes in the blue tilapia genome. Comparisons of predicted antimicrobial peptides between the blue tilapia and its close relative Nile tilapia proved that these immunological genes are highly similar with a genome-wide scattering distribution. As a valuable genetic resource, our blue tilapia genome assembly will benefit for biomedical researches and practical molecular breeding for high resistance to various diseases, which have been a critical problem in the aquaculture of tilapias.


Pharmacokinetic and pharmacodynamic study of suriclone imipramine interaction in man.
Suriclone is a novel cyclopyrrolone exhibiting anxiolytic activity. Twelve healthy Caucasian male volunteers participated in the study. A single dose of suriclone 0.4 mg, imipramine 75 mg, suriclone 0.4 mg + imipramine 75 mg, or placebo was given according to a 4 x 4 Latin-square design in order to assess the effect of drug association on pharmacokinetics and psychomotor performances. Visual analogue scale ratings, critical flicker frequency, choice visual reaction time, and Pauli, picture memory and Sternberg tests were performed before and 1.5, 6 and 9 h after drug administration. Suriclone, with the exception of the Pauli test, had no effect on psychomotor performances. The imipramine-suriclone association appeared to disturb some performances (no statistical significance), probably due to the effect of imipramine. Blood samples were collected for determination of imipramine and suriclone plasma levels respectively by high-performance liquid chromatography and radioimmunoassays. Suriclone AUC, Cmax and Tmax were not affected by imipramine, and reciprocally.


Sphingosine 1-phosphate induces Ca2+ transients and cytoskeletal rearrangement in C2C12 myoblastic cells.
In many cell systems, sphingosine 1-phosphate (SPP) increases cytosolic Ca2+ concentration ([Ca2+]i) by acting as intracellular mediator and extracellular ligand. We recently demonstrated (Meacci E, Cencetti F, Formigli L, Squecco R, Donati C, Tiribilli B, Quercioli F, Zecchi-Orlandini S, Francini F, and Bruni P. Biochem J 362: 349-357, 2002) involvement of endothelial differentiation gene (Edg) receptors (Rs) specific for SPP in agonist-mediated Ca2+ response of a mouse skeletal myoblastic (C2C12) cell line. Here, we investigated the Ca2+ sources of SPP-mediated Ca2+ transients in C2C12 cells and the possible correlation of ion response to cytoskeletal rearrangement. Confocal fluorescence imaging of C2C12 cells preloaded with Ca2+ dye fluo 3 revealed that SPP elicited a transient Ca2+ increase propagating as a wave throughout the cell. This response required extracellular and intracellular Ca2+ pool mobilization. Indeed, it was significantly reduced by removal of external Ca2+, pretreatment with nifedipine (blocker of L-type plasma membrane Ca2+ channels), and inositol 1,4,5-trisphosphate [Ins(1,4,5)P3]-mediated Ca2+ pathway inhibitors. Involvement of EdgRs was tested with suramin (specific inhibitor of Edg-3). Fluorescence associated with Ins(1,4,5)P3Rs and L-type Ca2+ channels was evident in C2C12 cells. SPP also induced C2C12 cell contraction. This event, however, was unrelated to [Ca2+]i increase, because the two phenomena were temporally shifted. We propose that SPP may promote C2C12 cell contraction through Ca2+-independent mechanisms.


Characterization of novel anti-mouse thyrotropin monoclonal antibodies.
Mouse hybridoma cell lines have been raised to a peptide of the mouse thyrotropin-beta (thyroid stimulating hormone [TSH]beta) subunit of the TSH glycoprotein hormone molecule. Using an enzyme-linked immunosorbent assay (ELISA) capture technique with two anti-TSHbeta monoclonal antibodies (MAbs), these reagents were found to have strong reactivity in a titration-dependent manner against normal mouse serum, and to precipitate under reducing conditions a 13-kDa product, the correct molecular size of the TSHbeta component, from mouse sera. These MAbs had minimal reactivity in ELISA to bovine and rat TSH and slight reactivity to human TSH, demonstrating overall strong species specificity for mouse TSH. Due to the large number of inbred and genetically manipulated mice now available for experimental research, it is anticipated that these reagents will be of considerable value for in-depth studies into TSH-related physiological processes in ways that have not been feasible here-to-fore.


Conductivitylike Gilbert Damping due to Intraband Scattering in Epitaxial Iron.
Confirming the origin of Gilbert damping by experiment has remained a challenge for many decades, even for simple ferromagnetic metals. Here, we experimentally identify Gilbert damping that increases with decreasing electronic scattering in epitaxial thin films of pure Fe. This observation of conductivitylike damping, which cannot be accounted for by classical eddy-current loss, is in excellent quantitative agreement with theoretical predictions of Gilbert damping due to intraband scattering. Our results resolve the long-standing question about a fundamental damping mechanism and offer hints for engineering low-loss magnetic metals for cryogenic spintronics and quantum devices.


OsLBD3-7 Overexpression Induced Adaxially Rolled Leaves in Rice.
Appropriate leaf rolling enhances erect-leaf habits and photosynthetic efficiency, which consequently improves grain yield. Here, we reported the novel lateral organ boundaries domain (LBD) gene OsLBD3-7, which is involved in the regulation of leaf rolling. OsLBD3-7 works as a transcription activator and its protein is located on the plasma membrane and in the nucleus. Overexpression of OsLBD3-7 leads to narrow and adaxially rolled leaves. Microscopy of flag leaf cross-sections indicated that overexpression of OsLBD3-7 led to a decrease in both bulliform cell size and number. Transcriptional analysis showed that key genes that had been reported to be negative regulators of bulliform cell development were up-regulated in transgenic plants. These results indicated that OsLBD3-7 might acts as an upstream regulatory gene of bulliform cell development to regulate leaf rolling, which will give more insights on the leaf rolling regulation mechanism.


Assessment of HIV disclosure and sexual behavior among Black men who have sex with men following a randomized controlled intervention.
Disclosure is important in human immunodeficiency virus (HIV) transmission risk reduction. This randomized controlled intervention assessed changes in and predictors of disclosure and risky sexual behavior among Black men who have sex with men (BMSM) living with HIV in the U.S. BMSM were randomly assigned to either the disclosure intervention or attention control case management group. Predictors of three disclosure types (behavior, beliefs, intentions) and condomless anal intercourse (CAI) included disclosure consequences (rewards and costs), disclosure readiness, and safer sex readiness. Mixed-effect results showed no differences between the groups in any of the outcomes; although disclosure behavior increased over time. Relationships were found between readiness to change and CAI; disclosure consequences and different disclosure types; and disclosure behavior and receptive CAI. When working with BMSM living with HIV, practitioners and prevention specialists should consider the importance of disclosure pertaining to receptive CAI and factors that support overall disclosure and safer sex.


Relation of age to isoenzyme pattern and total activity of amylase in serum.
Pancreatic and salivary isoenzymes of amylase were determined in serum from 70 subjects. Thin-layer gel/isoelectric focusing was used to separate the isoenzymes. Because other studies (J. Lab. Clin. Med. 90: 141-151, 1977) show that the major isoamylases have isoelectric points between 5.8 and 7.2, we focused the sera on polyacrylamide gel plates with a pH gradient from 5.5 to 8.5. The separated amylase fractions were made visible by direct incubation with a commercially available dye-starch polymer. Isoelectric focusing proved to be convenient, precise, and reproducible, and it can be used as a routine analysis to detect even slight changes in serum amylase distributions. We found that the isoamylase distribution is age dependent, whereas total amylase activity shows no correlation with age.


Prior exercise increases phosphorylation of Akt substrate of 160 kDa (AS160) in rat skeletal muscle.
The main purpose of this study was to determine whether the increased glucose transport (GT) found immediately postexercise (IPEX) or 4 h postexercise (4hPEX) is accompanied by increased phosphorylation of Akt substrate of 160 kDa (AS160, a protein regulator of GLUT4 translocation). Paired epitrochlearis muscles were dissected from rats (sedentary or IPEX, 2-h swim) and used to measure protein phosphorylation and insulin-independent GT. IPEX values exceeded sedentary values for GT and phosphorylations of AS160, AMP-activated protein kinase (pAMPK) and acetyl-CoA carboxylase (pACC) but not for AS160 abundance or phosphorylation of Akt serine (pSerAkt), Akt threonine (pThrAkt), or glycogen synthase kinase-3 (pGSK3). AS160 phosphorylation was significantly correlated with GT (R=0.801, P<0.01) and pAMPK (R=0.655, P<0.05). Muscles from other rats were studied 4hPEX along with sedentary controls. One muscle per rat was incubated without insulin, and the contralateral muscle was incubated with insulin. 4hPEX values exceeded sedentary values for insulin-stimulated GT. The elevated pAMPK and pACC found IPEX had reversed by 4hPEX. Insulin caused a significant increase in pSerAkt, pThrAkt, pGSK3, and AS160 phosphorylation with or without exercise. Exercise significantly increased AS160 phosphorylation, regardless of insulin, with unchanged AS160 abundance. Among the signaling proteins studied, insulin-stimulated GT was significantly correlated only with insulin-stimulated pThrAkt (R=0.720, P<0.0005). The results are consistent with a role for increased AS160 phosphorylation in the increased insulin-independent GT IPEX, and the exercise effects on AS160 phosphorylation and/or pThrAkt at 4hPEX are potentially relevant to the increased insulin-stimulated glucose transport at this time.


A Machine-Learning Algorithm to Predict the Likelihood of Prolonged Opioid Use Following Arthroscopic Hip Surgery.
To develop a machine-learning algorithm and clinician-friendly tool predicting the likelihood of prolonged opioid use (>90 days) following hip arthroscopy. The Military Data Repository was queried for all adult patients undergoing arthroscopic hip surgery between 2012 and 2017. Demographic, health history, and prescription records were extracted for all included patients. Opioid use was divided into preoperative use (30-365 days before surgery), perioperative use (30 days before surgery through 14 days after surgery), postoperative use (14-90 days after surgery), and prolonged postoperative use (90-365 days after surgery). Six machine-learning algorithms (Naïve Bayes, Gradient Boosting Machine, Extreme Gradient Boosting, Random Forest, Elastic Net Regularization, and artificial neural network) were developed. Area under the receiver operating curve and Brier scores were calculated for each model. Decision curve analysis was applied to assess clinical utility. Local-Interpretable Model-Agnostic Explanations were used to demonstrate factor weights within the selected model. A total of 6,760 patients were included, of whom 2,762 (40.9%) filled at least 1 opioid prescription >90 days after surgery. The artificial neural network model showed superior discrimination and calibration with area under the receiver operating curve = 0.71 (95% confidence interval 0.68-0.74) and Brier score = 0.21 (95% confidence interval 0.20-0.22). Postsurgical opioid use, age, and preoperative opioid use had the most influence on model outcome. Lesser factors included the presence of a psychological comorbidity and strong history of a substance use disorder. The artificial neural network model shows sufficient validity and discrimination for use in clinical practice. The 5 identified factors (age, preoperative opioid use, postoperative opioid use, presence of a mental health comorbidity, and presence of a preoperative substance use disorder) accurately predict the likelihood of prolonged opioid use following hip arthroscopy. III, retrospective comparative prognostic trial.


A comparative study of speech development between deaf children with cochlear implants who have been educated with spoken or spoken+sign language.
To compare speech development following unilateral cochlear implant (CI) between a group of prelingually deaf children who have been educated exclusively using spoken language and another group who have used two languages (spoken and sign language). A simple group quasi-experimental design was used with a control group. The sample comprised 7 girls and 11 boys, aged between 4 and 8 years old, who received a CI between the ages of 15 months and 5 years old. The sample was divided into two groups, G1-bilingual and G2-spoken language. In both groups, aspects such as speech intelligibility, receptive vocabulary, psycho-linguistic skills, adaptive behaviour and behavioural problems were measured. The children in Group 1 (bilingual) had better verbal and manual expression whereas those in Group 2 (spoken) achieved better results in terms of speech intelligibility, auditory reception and grammatical closure. These differences were confirmed statistically using Analysis of Variance. No significant differences were observed in relation to: receptive vocabulary, social and communicative skills, visual reception, auditory and visual association, visual closure and visual or auditory sequential memory. The development of speech in these children is irrefutable; however, this study contributes a paradoxical element to the discussion: the bilingual group obtained better results in verbal fluency, hence these children should be able to evoke a greater number of words than those educated using just spoken language.


Survey of Pediatric ICU EEG Monitoring-Reassessment After a Decade.
In 2011, the authors conducted a survey regarding continuous EEG (CEEG) utilization in critically ill children. In the interim decade, the literature has expanded, and guidelines and consensus statements have addressed CEEG utilization. Thus, the authors aimed to characterize current practice related to CEEG utilization in critically ill children. The authors conducted an online survey of pediatric neurologists from 50 US and 12 Canadian institutions in 2022. The authors assessed responses from 48 of 62 (77%) surveyed institutions. Reported CEEG indications were consistent with consensus statement recommendations and included altered mental status after a seizure or status epilepticus, altered mental status of unknown etiology, or altered mental status with an acute primary neurological condition. Since the prior survey, there was a 3- to 4-fold increase in the number of patients undergoing CEEG per month and greater use of written pathways for ICU CEEG. However, variability in resources and workflow persisted, particularly regarding technologist availability, frequency of CEEG screening, communication approaches, and electrographic seizure management approaches. Among the surveyed institutions, which included primarily large academic centers, CEEG use in pediatric intensive care units has increased with some practice standardization, but variability in resources and workflow were persistent.


Bruno Schulz's 1933 Monograph: On the Hereditary Etiology of Schizophrenia.
In his 1933 article, Bruno Schulz reported a follow-up and reanalysis of the schizophrenic probands and their relatives first studied by Rüdin 20 years earlier that sought to clarify whether schizophrenia was a valid "unit-character" for Mendelian genetic analysis. He proposed a range of subgroupings of probands, particularly traditional subtyping, presence or absence of identifiable causal influences, and outcome. He then compared those subgroupings in several ways, most commonly by the risk for schizophrenia in their siblings and by the level of resemblance among proband-sibling affected pairs. Of his many findings, those of greatest interest included (1) probands with possible and probable physical causes, particularly those with head trauma, had substantially lower risk of illness in siblings, (2) probands with a hebephrenic subtype had a striking elevation of risk for schizophrenia in siblings, (3) probands with psychological causes had higher rates of good outcome, (4) proband-sibling pairs resembled one another for the classical schizophrenic subtypes, and (5) an absence of any cases of schizophrenia in siblings of a small group of schizophrenic probands with birth complications, convulsions, and skull deformities. Schulz used this sample in a fundamentally different way than Rüdin. Rather than seeking for Mendelian transmission patterns, Schulz used family data to evaluate hypothesis about clinical/etiological heterogeneity, thereby presaging many subsequent family studies of psychiatric disorders. While Schulz did not claim to have proved the etiologic heterogeneity of schizophrenia, he raised important questions, still unanswered, about whether schizophrenia is a legitimate "unit-character" appropriate for genetic analysis.


Pitavastatin treatment induces neuroprotection through the BDNF-TrkB signalling pathway in cultured cerebral neurons after oxygen-glucose deprivation.
Along with their lipid-lowering effect, statins have been reported to have neuroprotective function in both in vivo and in vitro models of neurodegenerative diseases. We conducted this study in order to uncover the he neuroprotective effect of the lipophilic statin pitavastatin (PTV) and investigate the underlying molecular mechanisms using primary cultured cerebral neurons exposed to oxygen-glucose deprivation (OGD). The primary cultured cerebral neurons were randomly assigned into four groups: the control group, the pitavastatin treatment group, the OGD group and the OGD + pitavastatin treatment group. The pitavastatin's concentration were set as follows: 1μM, 15μM, 30μM. After 3 hours OGD treatment, we use MTT method to assessment cell viability, immunofluorescence to observe neuron morphology and western blot method analysis the BDNF, TrkB. PTV at concentrations of 1 μM and 15 μM elevated the survival rate of cortical neurons exposed to OGD, whereas 30 μM PTV did not show such an effect. Moreover, PTV promoted neuronal dendrite growth at concentrations of 1 μM and 15 μM. Increased expression levels of brain-derived neurotrophic factor (BDNF) and tropomyosin-related kinase B (TrkB) were observed in both of the following two scenarios: when neurons were treated with PTV for 48 hours and when PTV was added after the OGD procedure. Pitavastatin treatment induces neuroprotection in cultured cerebral neurons after oxygen-glucose deprivation this neuroprotection induced by PTV involves the BDNF-TrkB signalling pathway.


Hyaluronic Acid Is an Effective Dermal Filler for Lip Augmentation: A Meta-Analysis.
Introduction: The lips and the mouth play an indispensable role in vocalization, mastication and face aesthetics. Various noxious factors may alter and destruct the original structure, and appearance of the lips and the anatomical area surrounding the mouth. The application of hyaluronic acid (HA) may serve as a safe method for lip regeneration. Although a number of studies exist for HA effectiveness and safety, its beneficial effect is not well-established. Aim: The present meta-analysis and systematic review was performed to investigate the effectiveness of HA on lip augmentation. We also investigated the types and nature of adverse effects (AEs) of HA application. Methods: We reported our meta-analysis in accordance with the PRISMA Statement. PROSPERO protocol registration: CRD42018102899. We performed the systematic literature search in CENTRAL, Embase, and MEDLINE. Randomized controlled trials, cohort studies, case series and case reports were included. The untransformed proportion (random-effects, DerSimonian-Laird method) of responder rate to HA injection was calculated. For treatment related AEs descriptive statistics were used. Results: The systematic literature search yielded 32 eligible records for descriptive statistics and 10 records for quantitative synthesis. The results indicated that the overall estimate of responders (percentage of subjects with increased lip fullness by one point or higher) was 91% (ES = 0.91, 95% CI:0.85-0.96) 2 months after injection. The rate of responders was 74% (ES = 0.74, 95% CI:0.66-0.82) and 46% (ES = 0.46, 95% CI:0.28-0.65) after 6 and 12 months, respectively. We included 1,496 participants for estimating the event rates of AEs. The most frequent treatment-related AEs were tenderness (88.8%), injection site swelling (74.3%) and bruising (39.5%). Rare AEs included foreign body granulomas (0.6%), herpes labialis (0.6%) and angioedema (0.3%). Conclusion: Our meta-analysis revealed that lip augmentation with injectable HA is an efficient method for increasing lip fullness for at least up to 6 months after augmentation. Moreover, we found that most AEs of HA treatment were mild or moderate, but a small number of serious adverse effects were also found. In conclusion, further well-designed RCTs are still needed to make the presently available evidence stronger.