CeRNASeek: an R package for identification and analysis of ceRNA regulation.
Competitive endogenous RNA (ceRNA) represents a novel layer of gene regulation that controls both physiological and pathological processes. However, there is still lack of computational tools for quickly identifying ceRNA regulation. To address this problem, we presented an R-package, CeRNASeek, which allows identifying and analyzing ceRNA-ceRNA interactions by integration of multiple-omics data. CeRNASeek integrates six widely used computational methods to identify ceRNA-ceRNA interactions, including two global and four context-specific ceRNA regulation prediction methods. In addition, it provides several downstream analyses for predicted ceRNA-ceRNA pairs, including regulatory network analysis, functional annotation and survival analysis. With examples of cancer-related ceRNA prioritization and cancer subtyping, we demonstrate that CeRNASeek is a valuable tool for investigating the function of ceRNAs in complex diseases. In summary, CeRNASeek provides a comprehensive and efficient tool for identifying and analysis of ceRNA regulation. The package is available on the Comprehensive R Archive Network (CRAN) at https://CRAN.R-project.org/package=CeRNASeek.


Eurasian origin of Alismatidae inferred from statistical dispersal-vicariance analysis.
Alismatidae is a wetland or aquatic herb lineage of monocots with a cosmopolitan distribution. Although considerable progress in systematics and biogeography has been made in the past several decades, geographical origin of this group remains unresolved. In this study, we used statistical dispersal-vicariance analysis implemented in program RASP to investigate the biogeography of Alismatidae. Six areas of endemism were used to describe the distribution: North America, South America, Eurasia, Africa, Southeast Asia and Australia. 18,000 trees retained from Bayesian inference of rbcL served as a framework to reconstruct the ancestral areas. The results suggested that the most recent common ancestor of Alismatidae most probably occurred in Eurasia, followed by a split into two major clades. The clade comprising Hydrocharitaceae, Butomaceae and Alismataceae mainly diversified in Eurasia and Africa. The other clade comprising the remaining families dispersed to southern hemisphere. Australia played an important role in diversification of this clade. Several families were suggested to have occurred in Australia, such as Ruppiaceae, Cymodoceaceae, Posidoniaceae and Zosteraceae.


Two-quantum many-body coherences in two-dimensional fourier-transform spectra of exciton resonances in semiconductor quantum wells.
We present experimental coherent two-dimensional Fourier-transform spectra of Wannier exciton resonances in semiconductor quantum wells generated by a pulse sequence that isolates two-quantum coherences. By measuring the real part of the signals, we determine that the spectra are dominated by two-quantum coherences due to mean-field many-body interactions, rather than bound biexcitons. Simulations performed using dynamics controlled truncation agree with the experiments.


[Infectivity of the sparganum treated by praziquantel, gamma-irradiation and mechanical cutting].
An experimental study was performed to observe the infectivity of sparganum (plerocercoid of Spirometra erinacei) treated by praziquantel, gamma-irradiation and mechanical cutting. The spargana were obtained from the naturally infected European grass snake, Rhabdophis tigrina, or from the experimentally infected mice. A total of 83 mice (ICR strain) were divided into 3 experimental groups by the source of the damage, fed each with 5 spargana, and sacrificed 1 month later for worm recovery. In the praziquantel group, the worms were incubated in the concentration of 10 micrograms/ml (control: Tyrode for 4 hours) for 0.5, 1, 2 and 4 hours at 36 degrees C, and fed to mice. The recovery rate from mice in praziquantel group was not different from that (80%) of control group and in the range of 76-100%. In the gamma-irradiation group, the worms were irradiated by 10-1000 Gy with Cs137. The average recovery rates of 69-100% were not different from that of control up to 100 Gy. The rate was 56% under 150 Gy, and 5% by 1000 Gy. In the mechanical cutting group, the worms were cut at 0.5, 1, 2 and 3 mm from the anterior end of the scolex. The average recovery rates in each group were 70-90% and that of control was 90%. The present finding suggests that the sparganum be highly resistant to praziquantel, gamma-irradiation and mechanical cutting. The vitality center of the sparganum must be at the anterior end of its scolex.


[Staphylococcus aureus infections carrying Panton-Valentine leukocidin genes in hospitals: which statute should be given to these strains?].
The aim of the present study was to investigate the prevalence Staphylococcus aureus infections carrying Panton-Valentine leukocidin (LPV) genes in our hospital by screening patients that are hospitalised or admitted for consultation, as well as to study the characteristics of these strains and the respectively infected patients. A descriptive and retrospective study over the course of a 14 month period was conducted. The isolates of S. aureus were tested for antimicrobial resistance, in which detection of the virulence gene was performed by way of PCR, such as is the case for gene luk-PV which encoding the LPV. The genetic diversity of the strains carrying gene, luk-PV, was determined by way of pulsed-field gel electrophoresis and by the MLVA (Multiple Loci VNTR Analysis; VNTR, Variable Number of Tandem Repeats) method. 7.14% of the S. aureus isolates carried genes for LPV, which are primarily sourced from surgery, emergency, and outpatient consultation services. The nature of the reported infections is often surface, immediately collected, and more rarely deep. Genotyping revealed three principal clones that were gathering 55% of the strains, which in turn highlighted transmission to the nursing staff. These strains of S. aureus LPV+ have the capacity for diffusion and pathogenicity, which leads to the need to take some specific measures at hospitals: the tracking of the LPV during repeat or deep infections with S. aureus, possibly the search for conveyance and individual measures for the eradication of the strain. Lastly, it is necessary to increase the nursing staff's awareness of the appropriate hygiene measures when they come into contact with these patients.


Grazing of Tetrahymena sp. on adhered bacteria in percolated columns monitored by in situ hybridization with fluorescent oligonucleotide probes.
Predation of attached Pseudomonas putida mt2 by the small ciliate Tetrahymena sp. was investigated with a percolated column system. Grazing rates were examined under static and dynamic conditions and were compared to grazing rates in batch systems containing suspended prey. The prey densities were 2 x 10(8) bacteria per ml of pore space and 2 x 10(8) bacteria per ml of suspension, respectively. Postingestion in situ hybridization of bacteria with fluorescent oligonucleotide probes was used to quantify ingestion. During 30 min, a grazing rate of 1,382 +/- 1,029 bacteria individual-1 h-1 was obtained with suspended prey; this was twice the grazing rate observed with attached bacteria under static conditions. Continuous percolation at a flow rate of 73 cm h-1 further decreased the grazing rate to about 25% of the grazing rate observed with suspended prey. A considerable proportion of the protozoans fed on neither suspended bacteria nor attached bacteria. The transport of ciliates through the columns was monitored at the same time that predation was monitored. Less than 20% of the protozoans passed through the columns without being retained. Most of these organisms ingested no bacteria, whereas the retained protozoans grazed more efficiently. Retardation of ciliate transport was greater in columns containing attached bacteria than in bacterium-free columns. We propose that the correlation between grazing activity and retardation of transport is a consequence of the interaction between active predators and attached bacteria.


Is leukocytosis a predictor for recurrence of ischemic events after coronary artery bypass graft surgery? A cohort study.
Objective. Studies have shown that inflammation plays an important role in pathogenesis of coronary artery disease. The present study was designed to evaluate the role of high WBC count before CABG in predicting the risk of ischemic events after CABG. Methods and Results. This prospective study was carried out on 380 patients who underwent CABG surgery. Ninety seven patients (25.5%) had recurrent ischemic event. Mean WBC count before CABG surgery in patients with recurrent ischemic event was 7267 mic/lit ± 1863, which was significantly higher than the others, with a mean WBC count of 6721 mic/lit ± 1734 (P = 0.011). Patients with a WBC count more than 6000 mic/lit were at the highest risk for recurrent ischemic event (OR = 2.11, 95% CI = 1.18-3.44, P = 0.009). After adjustment for age, sex, family history, smoking, hyperlipidemia, Logestic Euro score, post opretive enzyme release (CK.mb), arterial graft and BMI, the relationship between the group with WBC count higher than 6000 mic/lit and recurrent of ischemic event remained significant (OR = 2.25, 95% CI = 1.2 to 4, P = 0.005). Conclusions. High WBC count before CABG surgery is an independent risk factor for ischemic events one year after the surgery.


[Hypothalamo-pituitary-testicular function in male Japanese monkeys (Macaca fuscata) in non-mating season].
We examined seasonal changes in serum testosterone and LH, and investigated mechanisms of reduction of testicular function in non-mating season in male Japanese monkeys. Blood samples were collected monthly throughout one year in 5 males, and hCG and LH-RH were administered to 5 and 3 animals, respectively, in non-mating and mating season. Serum testosterone and LH were measured by RIA. Serum testosterone showed the obvious seasonal changes, being low in March to August and high in October to February. Also we found the seasonal changes in LH being low in May to August and high in September to February. When hCG was administered to 5 monkeys in mating season (January), serum testosterone levels increased markedly 30 to 180 min after single administration and showed further increases after continuous administrations for four days. However, in non-mating season (August), serum testosterone showed a little increase for the same treatment as in mating season. These data showed that the reserve ability of testosterone secretion in testis in non-mating season decreased obviously in contrast to mating season. The increase of serum LH and testosterone levels in 3 males in non-mating season (July) after LH-RH single administration were less than those in mating season (December). In intermediate period (September) between non-mating season and mating season, LH showed higher level than that in mating season but the testosterone level was the same extent as in non-mating season.(ABSTRACT TRUNCATED AT 250 WORDS)


Pemigatinib for the treatment of myeloid/lymphoid neoplasms with FGFR1 rearrangement.
Myeloid/lymphoid neoplasms with fibroblast growth factor receptor-1 (FGFR1) rearrangements (MLNFGFR1) are rare entities with aggressive features and poor prognosis. Presentation is heterogeneous, ranging from myeloproliferative neoplasms (with or without eosinophilia) to T-cell lymphoma and acute leukemia. Historical treatments have been guided by the presenting phenotype with induction chemotherapy frequently used. Pemigatinib is a FGFR1-3 tyrosine kinase inhibitor that has demonstrated high complete hematologic and cytogenetic response rates in MLNFGFR1. We discuss the pathogenesis, presentation, and historical treatments for MLNFGFR1, in addition to clinical data using pemigatinib and other targeted therapies. Discussion of the mechanism of action and adverse events is also included. Pemigatinib represents a significant advance in the management of MLNFGFR1. High rates of complete hematologic and cytogenetic response have been observed. While direct comparative data are unavailable, outcomes appear favorable compared to conventional approaches. Long-term efficacy and tolerability are not yet known, and allogeneic hematopoietic stem cell transplant (alloHSCT) continues to be the treatment with the highest chance of long-term disease free survival in responding patients. Combinations of pemigatinib and chemotherapy, particularly for more aggressive phenotypes, warrant future investigation as does the use of pemigatinib maintenance following alloHSCT.


miR2Diabetes: A Literature-Curated Database of microRNA Expression Patterns, in Diabetic Microvascular Complications.
microRNAs (miRNAs) have been established as critical regulators of the pathogenesis of diabetes mellitus (DM), and diabetes microvascular complications (DMCs). However, manually curated databases for miRNAs, and DM (including DMCs) association studies, have yet to be established. Here, we constructed a user-friendly database, "miR2Diabetes," equipped with a graphical web interface for simple browsing or searching manually curated annotations. The annotations in our database cover 14 DM and DMC phenotypes, involving 156 miRNAs, by browsing diverse sample origins (e.g., blood, kidney, liver, and other tissues). Additionally, we provide miRNA annotations for disease-model organisms (including rats and mice), of DM and DMCs, for the purpose of improving knowledge of the biological complexity of these pathologies. We assert that our database will be a comprehensive resource for miRNA biomarker studies, as well as for prioritizing miRNAs for functional validation, in DM and DMCs, with likely extension to other diseases.


Periodic, pseudonoise waveforms for multifunction coherent ladar.
We report the use of periodic, pseudonoise waveforms in a multifunction coherent ladar system. We exploit the Doppler sensitivity of these waveforms, as well as agile processing, to enable diverse ladar functions, including high range resolution imaging, macro-Doppler imaging, synthetic aperture ladar, and range-resolved micro-Doppler imaging. We present analytic expressions and simulations demonstrating the utility of pseudonoise waveforms for each of the ladar modes. We also discuss a laboratory pseudonoise ladar system that was developed to demonstrate range compression and range-resolved micro-Doppler imaging, as well as the phase recovery common to each of the coherent modes.


Calpains and Coronary Vascular Disease.
Despite many advances in percutaneous and surgical interventions in the treatment of coronary artery disease (CAD), up to one-third of patients are still either not candidates or receive suboptimal revascularization. Calpains are a class of calcium-activated non-lysosomal cysteine proteases that serve as a proteolytic unit for cellular homeostasis. Uncontrolled activation of calpain has been found to be involved in the pathogenesis of myocardial reperfusion injury, cardiac hypertrophy, myocardial stunning and cardiac ischemia. Inhibition of calpains has been shown to significantly attenuate myocardial stunning and reduced infarct size after ischemia-reperfusion. Calpain inhibition therefore serves as a potential medical therapy for patients suffering from a number of diseases, including CAD.


Determining the Physical Properties of Molecules with Nanometer-Scale Pores.
Nanometer-scale pores have been developed for the detection, characterization, and quantification of a wide range of analytes (e.g., ions, polymers, proteins, anthrax toxins, neurotransmitters, and synthetic nanoparticles) and for DNA sequencing. We describe the key requirements that made this method possible and how the technique evolved. Finally, we show that, despite sound theoretical work, which advanced both the conceptual framework and quantitative capability of the method, there are still unresolved questions that need to be addressed to further improve the technique.


[Case with probable dementia with Lewy bodies, who shows reduplicative paramnesia and Capgras syndrome].
We report a case of probable dementia with Lewy bodies (DLB), showing reduplicative paramnesia (RP) and Capgras syndrome (CS). The patient, a right-handed 60 year-old male, began to show progressive dementia. At the age of 65, he showed fluctuating cognitive impairment and recurrent visual hallucinations. His SPECT demonstrated hypoperfusion not in the medial temporal cortices, but in the parieto-occipital lobes, where the right hemisphere was dominantly hypoperfused. He was diagnosed with probable DLB. In addition to recurrent visual hallucinations, he showed a sense of self- (or others) transfiguration, consciousness of something non-existent (Leibhaftige Bewusstheit; Jaspers, K.), and fluctuating visuo-spacial impairment. At the age of 67, he gradually complained of his duplicative wives "sosie". Finally he went so far as to talk about a nameless phantom boarder. We considered that RP and CS of this case comprised a sense of self-(or others) transfiguration, misidentification of important persons and places, and productive symptoms such as consciousness of something non-existent (Leibhaftige Bewusstheit) and visual hallucinations. The above mentioned symptoms might be originated not only from the disturbance of visuospacial recognition, which involves the limbic system (especially amygdala), medial frontal cortex, and right hemisphere of the brain, but also from the disturbance of recursive consciousness, due to diffusely damaged brain regions with Lewy body pathology. (Authors' abstract)


Environmental Factors Associated with the Presence of Vibrionaceae in Tropical Cage-Cultured Marine Fishes.
This study investigated the environmental factors associated with the presence of Vibrionaceae in economically important cage-cultured tropical marine fishes: the Asian Seabass Lates calcarifer, snapper Lutjanus sp., and hybrid grouper Epinephelus sp. Fish sampling was conducted at monthly intervals between December 2016 and August 2017. The body weight and length of individual fish were measured, and the skin, eye, liver, and kidney were sampled for bacterial isolation and identification. Water physicochemical parameters during the sampling activities were determined, and the enumeration of total Vibrionaceae count was also conducted from water and sediment samples. Nine species of Vibrio were identified, including V. alginolyticus, V. diabolicus, V. harveyi, V. campbellii, V. parahaemolyticus, V. rotiferianus, V. furnissii, V. fluvialis, and V. vulnificus. Photobacterium damselae subsp. damselae was also identified. A total of 73% of the isolated Vibrio belonged to the Harveyi clade, followed by the Vulnificus clade (5.5%) and Cholera clade (0.6%). Highest occurrence of Vibrio spp. and P. damselae subsp. damselae was found in hybrid grouper (72%), followed by Asian Seabass (48%) and snapper (36%). The associations of Vibrio spp. and P. damselae subsp. damselae with the host fish were not species specific. However, fish mortality and fish size showed strong associations with the presence of some Vibrio spp. On average, 60% of the infected cultured fish exhibited at least one clinical sign. Nevertheless, inconsistent associations were observed between the pathogens and water quality. The yearlong occurrence and abundance of Vibrionaceae in the environmental components indicate that they might serve as reservoirs of these pathogens.


How Do We Study the Dynamic Structure of Unstructured Proteins: A Case Study on Nopp140 as an Example of a Large, Intrinsically Disordered Protein.
Intrinsically disordered proteins (IDPs) represent approximately 30% of the human genome and play key roles in cell proliferation and cellular signaling by modulating the function of target proteins via protein-protein interactions. In addition, IDPs are involved in various human disorders, such as cancer, neurodegenerative diseases, and amyloidosis. To understand the underlying molecular mechanism of IDPs, it is important to study their structural features during their interactions with target proteins. However, conventional biochemical and biophysical methods for analyzing proteins, such as X-ray crystallography, have difficulty in characterizing the features of IDPs because they lack an ordered three-dimensional structure. Here, we present biochemical and biophysical studies on nucleolar phosphoprotein 140 (Nopp140), which mostly consists of disordered regions, during its interaction with casein kinase 2 (CK2), which plays a central role in cell growth. Surface plasmon resonance and electron paramagnetic resonance studies were performed to characterize the interaction between Nopp140 and CK2. A single-molecule fluorescence resonance energy transfer study revealed conformational change in Nopp140 during its interaction with CK2. These studies on Nopp140 can provide a good model system for understanding the molecular function of IDPs.


Is unexplained elevated maternal serum alpha-fetoprotein still important predictor for adverse pregnancy outcome?
The purpose of this study was to determined the predictive value of maternal serum alpha-fetoprotein (MSAFP) as a marker for adverse pregnancy outcomes. This study was carried out at Dr. Zekai Tahir Burak Women's Health Education and Research Hospital between 2009 and 2010. This study included a total of 1,177 pregnant women, including 170 in the study group and 1,007 in the control group. Pregnancy outcomes and characteristics were analyzed with regard to the MSAFP value. Gestational week, birth weight and APGAR scores were significantly lower in the elevated MSAFP group (p < 0.001). Adverse pregnancy outcomes, such as preterm delivery, preterm premature rupture of membranes (PPROM), oligohydramnios and intrauterine growth restriction (IUGR) rates were increased in the elevated MSAFP group. Although ultrasound outweighs as a screening method for neural tube defects and non-invasive prenatal testing outweighs for aneuploidy screening MSAFP level in the second trimester is still an important predictor for poor maternal/fetal outcomes.


Regulatory T-Cell Therapy in Transplantation and Severe Autoimmunity.
Current approaches to prevent or treat transplant rejection, graft-versus-host disease and severe autoimmunity rely on non-specific immunosuppressive drugs. Ongoing efforts aimed at harnessing regulatory T (Treg) cells hold promise for revolutionizing the current therapeutic options, reducing if not abandoning immune suppression in favor of immune tolerance. This paradigm shift carries the potential of dramatically enhancing efficacy, persistency, and specificity while reducing side effects. Here, we review the various strategies devised to manipulate Treg cells in vitro and in vivo, the clinical progress achieved to date, and critical issues that still need to be addressed.


Dose escalation in prostate radiotherapy up to 82 Gy using simultaneous integrated boost: direct comparison of acute and late toxicity with 3D-CRT 74 Gy and IMRT 78 Gy.
To compare acute and late toxicity after three-dimensional conformal radiotherapy to the prostate to 74 Gy (3D-CRT) with intensity-modulated radiotherapy to 78 Gy (IMRT 78) and IMRT using simultaneous integrated boost to 82 Gy (IMRT/SIB 82). 94 patients treated with 3D-CRT to the prostate and base of seminal vesicles to 74 Gy represented the first group. The second group consisted of 138 patients subjected to IMRT covering the prostate and base of seminal vesicles to 78 Gy. The last group was treated with IMRT using SIB. The prescribed doses were 82 Gy and 73.8 Gy in 42 fractions to the prostate and seminal vesicles. Late toxicity was prospectively scored according to the RTOG/FC-LENT scale. Acute gastrointestinal toxicity >or= grade 2 occurred in 35.1% of patients treated with 3D-CRT, in 16% subjected to IMRT 78, and in 7.7% receiving IMRT/SIB 82. Acute genitourinary toxicity >or= grade 2 was observed in 26.6% (3D-CRT), 33% (IMRT 78), and 30.7% (IMRT/SIB 82). At 3 years, the estimated cumulative incidence of grade 3 late gastrointestinal toxicity was 14% for 3D-CRT, 5% for IMRT 78, and 2% for IMRT/SIB 82. The difference became significant (log rank p = 0.02). The estimated cumulative incidence of grade 3 late genitourinary toxicity was 9% (3D-CRT), 7% (IMRT 78), and 6% (IMRT/SIB 82) without statistical differences (log rank p = 0.32) SIB enables dose escalation up to 82 Gy with a lower rate of gastrointestinal toxicity grade 3 in comparison with 3D-CRT up to 74 Gy.


InSb focal plane array chemical imaging enables assessment of unit process efficiency for milling operation.
In the dry milling of wheat flour, each unit process (roller mill, purifier, sifter, etc.) produces a mixture with varying amounts of wheat endosperm and non-endosperm byproducts. Chemical images with 82 000 pixels of each intermediate product stream issuing from an individual processing machine are readily analyzed in terms of the relative amount of endosperm and non-endosperm. Approximately three minutes is required to produce an image of each intermediate product stream. Applying partial least squares (PLS) chemometric software to identify individual pixels, which enables calculation of the relative amount of endosperm and non-endosperm, is not a time-limiting factor. When relative flow rates are known for each stream, mass balance can be calculated from each intermediate stream in terms of the product (endosperm content) and the lower value non-endosperm byproduct. Data is presented from a purifier in a commercial flour mill. Intermediate streams collected from a run with optimized operational parameters were compared to those of another run before adjustment. The endosperm (product) mass balance profile for each run enabled assessment of operational efficiency. The devised chemical imaging analysis system would be particularly useful in commissioning of a new mill or to optimize existing wheat milling systems. Also, when raw material differs from that for which previous optimization was established, a new optimization may be in order. The ability to acquire a large number of spectra from a specimen and apply multivariate statistics to identify each pixel and subsequently count pixels accommodates heterogeneity and reports the results from averaging a very large number of individual spectra. A second illustration of the utility of the imaging method is presented centering on streams from the first and second break unit operations at the beginning of the roller mill process.


Genetic associations with suicide attempt severity and genetic overlap with major depression.
In 2015, ~800,000 people died by suicide worldwide. For every death by suicide there are as many as 25 suicide attempts, which can result in serious injury even when not fatal. Despite this large impact on morbidity and mortality, the genetic influences on suicide attempt are poorly understood. We performed a genome-wide association study (GWAS) of severity of suicide attempts to investigate genetic influences. A discovery GWAS was performed in Yale-Penn sample cohorts of European Americans (EAs, n = 2,439) and African Americans (AAs, n = 3,881). We found one genome-wide significant (GWS) signal in EAs near the gene LDHB (rs1677091, p = 1.07 × 10-8) and three GWS associations in AAs: ARNTL2 on chromosome 12 (rs683813, p = 2.07 × 10-8), FAH on chromosome 15 (rs72740082, p = 2.36 × 10-8), and on chromosome 18 (rs11876255, p = 4.61 × 10-8) in the Yale-Penn discovery sample. We conducted a limited replication analysis in the completely independent Army-STARRS cohorts. rs1677091 replicated in Latinos (LAT, p = 6.52 × 10-3). A variant in LD with FAH rs72740082 (rs72740088; r2 = 0.68) was replicated in AAs (STARRS AA p = 5.23 × 10-3; AA meta, 1.51 × 10-9). When combined for a trans-population meta-analysis, the final sample size included n = 20,153 individuals. Finally, we found significant genetic overlap with major depressive disorder (MDD) using polygenic risk scores from a large GWAS (r2 = 0.007, p = 6.42 × 10-5). To our knowledge, this is the first GWAS of suicide attempt severity. We identified GWS associations near genes involved in anaerobic energy production (LDHB), circadian clock regulation (ARNTL2), and catabolism of tyrosine (FAH). These findings provide evidence of genetic risk factors for suicide attempt severity, providing new information regarding the molecular mechanisms involved.


Impact of pulmonary fibrosis and elevated pulmonary pressures on right ventricular function in patients with systemic sclerosis.
Right ventricular (RV) dysfunction is of great prognostic value in patients with SSc. The aim of the present study was to assess in these patients the relationship between pulmonary fibrosis and elevated pulmonary pressure (PHT) with RV function. A total of 102 SSc patients who underwent thoracic CT and transthoracic echocardiography were included. Speckle tracking-derived RV free wall strain was used to assess RV function. A total of 51 (50%) SSc patients did not have pulmonary fibrosis or PHT, 32 (31%) patients had pulmonary fibrosis but no PHT and the remaining 19 (19%) patients had both pulmonary fibrosis and PHT. Patients with both pulmonary fibrosis and PHT had the most impaired RV free wall strain [-16.8% (s.d. 3.1)] compared with patients with pulmonary fibrosis and no PHT [-21.5% (s.d. 3.6)] and patients with no pulmonary fibrosis and no PHT [-24.0% (s.d. 4.4)]. All three SSc groups showed impaired RV free wall strain compared with controls [-28.0% (s.d. 4.2)]. Importantly, multivariate regression analysis demonstrated that pulmonary fibrosis and left ventricular ejection fraction were independently associated with impaired RV free wall strain in SSc patients. SSc patients show impaired RV function compared with controls. Both pulmonary fibrosis and PHT are independently associated with RV dysfunction.


Numerical optimization of temperature-time degradation of multiple mycotoxins.
Mycotoxins are potent food contaminants that exert significant deleterious effects on human and animal health, yet, there is limited and often conflicting data on their thermal stability. The present study systematically investigated the thermal degradation patterns of multiple mycotoxins as a function of temperature and time, in pure form and spiked into a food matrix (maize flour), using a numerical modelling approach. Mycotoxins under investigation included aflatoxins (AFs), fumonisins (FBs), zearalenone and its analogue α and β epimers (ZEAs), ochratoxins (OTs), T-2 toxin (T-2), alternariol monomethyl ether (AME) and sterigmatocystin (STEG). A set of statistically-designed experiments were conducted, and a second-order optimization function fitted to the experimental data. The resultant models were well fit with R2 values ranging from 0.87 to 0.99 and 0.89 to 0.99, for pure mycotoxin standards and spiked maize flour, respectively. It was also possible to statistically determine the optimum degradation conditions which were 216.57 °C/63.28 min and 210.85 °C/54.71 min for pure mycotoxins and spiked into maize flour, respectively. Our observations herein could be critical for food safety applications targeted at reducing or at best eliminating completely multi-mycotoxins in food using heat processing while limiting the destruction of food quality factors.


Estimation of Airborne Vapor Concentrations of Oil Dispersants COREXIT™ EC9527A and EC9500A, Volatile Components Associated with the Deepwater Horizon Oil Spill Response and Clean-up Operations.
The Deepwater Horizon (DWH) drilling unit explosion above the Macondo oil well on 20 April 2010 caused the release of approximately 4.9 million barrels (779 million L) of oil into the Gulf of Mexico. As part of a larger spill response and clean-up effort, approximately 1.84 million gallons (6.81 million L) of chemical dispersants COREXIT™ EC9500A and COREXIT™ EC9527A were applied to the resultant oil slicks through spraying on the water surface by plane and by vessel and through injection at the release source near the seabed. The GuLF STUDY is investigating the health effects of workers involved in the oil spill response and clean-up after the DWH explosion, and estimates of possible exposure to chemical dispersants were needed. Exposures were estimated to the volatile components of COREXIT™ EC9500A [petroleum distillates, hydrotreated light, and propylene glycol (PG)] and of COREXIT™ EC9527A [2-butoxyethanol (2-BE) and PG] using two of AIHA IHMOD2.0© mathematical modeling tools along with the dispersants' chemical and physical properties. Monte Carlo simulations were used to reflect uncertainty in input parameters with both the two-box, constant emission model and the near and mid field plume model for indoor and outdoor activities, respectively. Possible exposure scenarios considered various evaporation rates, sizes of the dispersant pool, wind speeds, and ventilation rates. For the two-box model, mean near field exposure estimates to 2-BE ranged from 0.9 to 5.7 ppm, while mean far field estimated exposures ranged from 0.3 to 3.5 ppm. Estimates of mean near field plume model exposures ranged from 0.01 to 3.7 ppm at 2.5 ft from the source, and <0.01 to 0.3 ppm at 10 ft from the source. Estimated exposures to PG were approximately 10% of the calculated 2-BE exposures and exposures to petroleum distillates about 40% higher than the 2-BE estimates. Results indicate that compared with current occupational exposure guidelines, overexposure to petroleum distillates and PG probably did not occur in our study, but under some conditions, for short periods, exposure to 2-BE may have exceeded the limits for peak exposures. These estimates were developed for use in job-exposure matrices to estimate exposures of workers having contact with dispersant vapors for the GuLF STUDY.


Self-adjuvanting influenza candidate vaccine presenting epitopes for cell-mediated immunity on a proteinaceous multivalent nanoplatform.
We exploit the features of a virus-like particle, adenoviral dodecahedron (Ad Dd), for engineering a multivalent vaccination platform carrying influenza epitopes for cell-mediated immunity. The delivery platform, Ad Dd, is a proteinaceous, polyvalent, and biodegradable nanoparticle endowed with remarkable endocytosis activity that can be engineered to carry 60 copies of a peptide. Influenza M1 is the most abundant influenza internal protein with the conserved primary structure. Two different M1 immunodominant epitopes were separately inserted in Dd external positions without destroying the particles' dodecahedric structure. Both kinds of DdFluM1 obtained through expression in baculovirus system were properly presented by human dendritic cells triggering efficient activation of antigen-specific T cells responses. Importantly, the candidate vaccine was able to induce cellular immunity in vivo in chickens. These results warrant further investigation of Dd as a platform for candidate vaccine, able to stimulate cellular immune responses.


Staff perceptions implementing interprofessional team-based behavioural healthcare.
The US Veterans Health Administration (VHA) in 2013 mandated a nationwide implementation of interprofessional team-based care in the general mental health setting and officially endorsed the collaborative care model in 2015 to guide the coordinated and anticipatory care to be delivered by these teams. Front-line clinic staff are major stakeholders whose practices are most directly affected by this implementation and may or may not view teams as useful or feasible for their practice. Our objective was to examine their perspectives on delivering team-to-patient care in order to understand what system-level efforts can best support the transition to such care from the more conventional provider-to-patient care. We conducted 14 semi-structured interviews with staff from general mental health clinics across three different VHA medical facilities. The interview questions focused on asking how care is organised and delivered at their clinic, their experiences in collaborating with other staff, and how the clinic handles changes. Four recurrent themes were identified: navigating workplace supervision, organisation, and role structures; continuing professional growth and relationships; delivering patient-focused care through education and connection to resources; and utilising information technology for communication and panel-based management. Quality improvement efforts were rarely discussed during the interviews. Our results indicate that staff's endorsement of the implementation of interprofessional care teams in general mental health settings may be strengthened through associated efforts targeted at enhancing their experiences aligned to these emergent themes.


Carcinogenicity of petroleum lubricating oil distillates: effects of solvent refining, hydroprocessing, and blending.
Certain refining processes were investigated to determine their influence on the dermal carcinogenic activity of petroleum-derived lubricating oil distillates. Specifically, the effects of solvent refining, hydroprocessing, a combination of both processes, and the blending of oils processed using each technique were evaluated in standard mouse skin-painting bioassays. The refining process used as well as the level or severity of treatment greatly influenced the carcinogenic outcome of processed lubricating oils. Solvent refining at severities normally used appeared to eliminate carcinogenicity. In contrast, hydroprocessing alone at mild levels of treatment was successful only in reducing the carcinogenic potency; severe hydroprocessing conditions were necessary to eliminate carcinogenic activity without the use of additional refining processes. Carcinogenic activity could also be eliminated by following moderate solvent refining with mild hydroprocessing. Blending of hydroprocessed oils with solvent-refined oils resulted in a substantial reduction or even elimination of carcinogenic activity. However, the degree of protection obtained varied with the particular distillates used and appeared largely dependent on the inherent biological activity of the hydroprocessed oil.


Monoclonal antibodies for chronic migraine and medication overuse headache: A real-world study.
Medication-overuse headache is highly prevalent in tertiary care centers. It may be a cause or consequence of the overuse of symptomatic medications for migraine attacks. We aimed to compare the efficacy of anti-CGRP monoclonal antibodies (mAbs) added to conventional pharmacological treatments in patients with chronic migraine (CM) and medication overuse headache (MOH). A cross-sectional, prospective, randomized, open study with real-world comparison groups of patients was carried out. The sample consisted of 200 patients with CM and MOH, who received the same approach to withdraw overused medications, started preventative treatment, and either did or did not receive mAbs. A total of 172 patients (126 women and 46 men) were included in the study and divided into two groups: group one consisting of 58 patients (control) and group two of 114 patients who used mAbs added to conventional pharmacological agents. The mean age was 44.1 ± 13.6 years, ranging from 18 to 78 years. In the 3 months follow-up after starting the treatment, both groups presented headache frequency reduction, but those with monoclonal antibodies had a significantly higher reduction in the number of headache days and symptomatic medication intake when compared to the control (p < 0.0001). The addition of an anti-CGRP monoclonal antibody to the treatment for medication overuse headaches in chronic migraineurs may result in decreasing headache frequency and symptomatic medication use when compared to conventional treatments with drugs.


Correction of deep static glabellar lines with acellular dermal matrix insertion.
The glabellar rhytid has not only dynamic but also static cause, which is usually achieved by injection of filler. Deep glabellar rhytides, however, are difficult to correct with filler. Therefore, the authors introduce a novel method of inserting a small strip of acellular dermal matrix (ADM) underneath the wrinkle line. From May 2009 to March 2012, 30 patients were treated for deep glabellar wrinkles with ADM augmentation by the senior author. The surgical outcomes were evaluated by the physician using the Lemperle scale and questionnaires filled out by the patients. The deep rhytides were significantly improved after the procedure, as evaluated by objective and subjective measurements, and their improvement lasted for a long period. No complications such as hematomas or infection were seen on postoperative follow-up. Augmentation with ADM provides a simple, easy, and minimally invasive option for the treatment of deep glabellar wrinkles. In cases of deep glabellar lines that cannot be corrected by filler injection, this procedure can be recommended as another option.


A symptom-based algorithm for calcium management after thyroid surgery: a prospective multicenter study.
Evidence-based treatment guidelines for the management of postthyroidectomy hypocalcemia are absent. The aim of this study was to evaluate a newly developed symptom-based treatment algorithm including a protocolized attempt to phase out supplementation. In a prospective multicenter study, patients were treated according to the new algorithm and compared to a historical cohort of patients treated with a biochemically based approach. The primary outcome was the proportion of patients receiving calcium and/or alfacalcidol supplementation. Secondary outcomes were calcium-related complications and predictors for supplementation. One hundred thirty-four patients were included prospectively, and compared to 392 historical patients. The new algorithm significantly reduced the proportion of patients treated with calcium and/or alfacalcidol during the first postoperative year (odds ratio (OR): 0.36 (95% CI: 0.23-0.54), P < 0.001), and persistently at 12 months follow-up (OR: 0.51 (95% CI: 0.28-0.90), P < 0.05). No severe calcium-related complications occurred, even though calcium-related visits to the emergency department and readmissions increased (OR: 11.5 (95% CI: 4.51-29.3), P <0.001) and (OR: 3.46 (95% CI: 1.58-7.57), P < 0.05), respectively. The proportional change in pre- to postoperative parathyroid hormone (PTH) was an independent predictor for supplementation (OR: 1.04 (95% CI: 1.02-1.07), P < 0.05). Symptom-based management of postthyroidectomy hypocalcemia and a protocolized attempt to phase out supplementation safely reduced the proportion of patients receiving supplementation, although the number of calcium-related hospital visits increased. For the future, we envision a more individualized treatment approach for patients at risk for delayed symptomatic hypocalcemia, including the proportional change in pre- to post- operative PTH.


IgD in nasopharyngeal secretions and tonsils from otitis-prone children.
Quantification of IgD was performed by ELISA in 180 plasma samples and 83 nasopharyngeal secretions (NPS) from children aged 2-162 months with varying degrees of recurrent otitis media. Furthermore, in 24 of the children the density of the IgD-immunocytes (IgD-cells) was calculated in immunoenzyme-stained cross-sections of their nasopharyngeal tonsils (NPT). Owing to a considerable variation of the IgD cell density throughout the NPT, a semi-quantitative counting system was applied. An irregular distribution of plasma IgD was observed during childhood and maximum levels were found between 48 and 72 months of age. However, an even distribution of plasma IgD was found among the four groups of children investigated. Based on calculations of the transudation of albumin from plasma to the NPS the amount of locally produced IgD in NPS (NPS-IgD (local] was estimated to 88% (range 41-99%). Significantly higher levels of NPS-IgD (local) were found in otitis-prone children than in the other groups. Moreover, a positive correlation was calculated between levels of NPS-IgD (local) and NPT-IgD cell density, indicating that NPT, being the local lymphoepithelial tissue, also functions as an important source of NPS-IgD. NPS-IgD was not found to be associated with secretory component, indicating a passive transfer of IgD through the mucosal membranes. Our results support the hypothesis of an association between the occurrence of IgD in the mucosa and secretions of the upper respiratory tract with localized inflammatory events.


Monatomic reactions with single vacancy monolayer h-BN: DFT studies.
Hexagonal boron nitride (h-BN) has been widely utilized in various strategic applications. Fine-tuning properties of BN towards the desired application often involves ad-atom adsorption of modifying its geometries through creating surface defects. This work utilizes accurate DFT computations to investigate adsorption of selected 1st and 2nd row elements (H, Li, C, O, Al, Si, P, S) of the periodic table on various structural geometries of BN. The underlying aim is to assess the change in key electronic properties upon the adsorption process. In addition to the pristine BN, B and N vacancies were comprehensively considered and a large array of properties (i.e., atomic charges, adsorption energies, density of states) were computed and contrasted among the eight elements. For instance, we found that the band gap to vary between 0.33 eV (in case of Li) and 4.14 eV (in case of P). Likewise, we have illustrated that magnetic contribution to differ substantially depending on the adatom adsorbents. Results from this work has also lays a theoretical foundation for the use of decorated and defected BN as a chemical sensor for CO gases.


Diagnostic value of eosinopenia and neutrophil to lymphocyte ratio on early onset neonatal sepsis.
To determine the diagnostic value of eosinopenia and the neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of early onset neonatal sepsis (EONS). This cross-sectional study was conducted in the Neonatology Ward of R.D. Kandou General Hospital Manado between July and October 2017. Samples were obtained from all neonates meeting the inclusion criteria for EONS. Data were encoded using logistic regression analysis, the point-biserial correlation coefficient, chi-square test, and receiver operating characteristic curve analysis, with a P value <0.05 considered significant. Of 120 neonates who met the inclusion criteria, 73 (60.8%) were males and 47 (39.2%) were females. Ninety (75%) were included in the sepsis group and 30 (25%) in the nonsepsis group. The mean eosinophil count in EONS and non-EONS groups was 169.8±197.1 cells/mm3 and 405.7±288.9 cells/ mm3 , respectively, with statistically significant difference (P<0.001). The diagnostic value of eosinopenia in the EONS group (cutoff point: 140 cells/mm3 ) showed 60.0% sensitivity and 90.0% specificity. The mean NLR in EONS and non-EONS groups was 2.82±2.29 and 0.82±0.32, respectively, with statistically significant difference (P<0.001). The diagnostic value of NLR in the EONS group (cutoff point, 1.24) showed 83.3% sensitivity and 93.3% specificity. Eosinopenia has high specificity as a diagnostic marker for EONS and an increased NLR has high sensitivity and specificity as a diagnostic marker for EONS.


Synthesis and in vitro antibacterial behavior of curcumin-conjugated gold nanoparticles.
Owing to the rise in multidrug-resistant bacterial diseases and the dwindling supply of newer antibiotics, it is crucial to discover newer compounds or modify current compounds for more effective antimicrobial therapies. According to reports, more than 80% of bacterial infections have been linked to bacterial biofilms. In addition to having antimicrobial properties, the hydrophobic polyphenol curcumin (Cur) also inhibits quorum sensing. The application of curcumin was constrained by its weak aqueous solubility and quick degradation. Over the past years, nanotechnology-based biomaterials with multi-functional characteristics have been engineered with high interest. The present study focused on the development of nano-biomaterials with excellent testifiers for bacterial infection in vitro. In this study, water dispersibility and stability of curcumin were improved through conjugation with gold nanoparticles. The successful synthesis of curcumin-conjugated gold nanoparticles (Cur-AuNPs) was confirmed using X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and UV-vis absorbance spectroscopy. Transmission electron microscopy (TEM) revealed an average particle size of about 10-13 nm. The antibacterial characteristics in terms of the minimum inhibitory concentration (MIC) of Cur-AuNP treatments were found to be lowest than those with AuNPs and Cur treatments. The quantitative analysis revealed the superior antibacterial characteristics of Cur-AuNP-treated bacterial cells compared to the untreated samples. In addition, curcumin-conjugated AuNPs, produced more reactive oxygen species and increased the membrane permeability. Besides, the biocompatibility of Cur-AuNPs was also assessed quantitatively and qualitatively. Statistical analyses revealed the augmented MG-63 cell proliferation in Cur-AuNPs compared to those with Cur and AuNPs treatments. Overall, Cur-AuNPs exhibited enhanced antibacterial, and antibiofilm characteristics and cytocompatibility.


Coronary artery changes 3 years after reimplantation of an anomalous right coronary artery.
In this paper we report the sequelae of a patient with an anomalous right coronary artery (RCA) originating from the pulmonary artery (PA) in association with a normal heart, operated upon at the age of 13 years. Three years after the end-to-side reimplantation of the RCA, with a rim of the PA, into the aorta, the surgical result has been evaluated by cineangiography. Before operation both coronary arteries were tortuous and increased in size. Afterwards the left coronary artery showed a normalized calibre, although the RCA remained tortuous with no decrease of the internal diameter. The notable postoperative changes in shape and size of the LCA may be due to the disappearance of the steal phenomenon. The lack of involutive changes in the RCA could be explained by its thinner wall. Left ventricular wall motion, evaluated under resting conditions and during an atrial pacing stress test, was found to be normal.


Morphological and histochemical observations on the duodenal glands of eight wild ungulate species native to North America.
The duodenal glands of the species examined (Alces alces, Ovis canadensis, Cervus canadensis, Oreamnos americanus, Bison bison, Antilocapra americana, Odocoileus virginianas, Odocoileus heminous) are confined primarily to the submucosa of the small intestine. In one species, the moose, a significant population of secretory tubules also is observed in the mucosa. The ducts of the duodenal glands pierce the overlying muscularis mucosae to empty most often independently into the intestinal lumen. Those of the bison, unlike the other species examined, drain into intestinal glands. The duodenal glands consist primarily of a simple columnar epithelium, the cells of which contain basally positioned round or oval nuclei. The lumina of scattered duodenal glands in the pronghorn and to some extent those of the moose, white-tailed deer, and mule deer may be extremely dilated, and the surrounding epithelium thin and attenuated. Component cells of the duodenal glands of all the species examined show remarkably similar ultrastructural features. They exhibit scattered profiles of rough endoplasmic reticulum, dilated cisternae of which contain an electron-dense, amorphous material. Numerous well-developed Golgi complexes occupy the supranuclear region together with transport vesicles and forming secretory granules. Electron-dense, membrane-bound secretory granules generally are concentrated in the apical cytoplasm immediately subjacent to the cell membrane. The apical cell membrane exhibits short, scattered microvilli; and the basal cell membrane is smooth without apparent specialization. Histochemically, the duodenal glands of most species examined in this study consist of a heterogeneous population. The majority of the glands of the moose, elk, mountain goat, bison, pronghorn, and white-tailed deer elaborate a neutral mucin, whereas scattered individual glands, tubules or cells also produce acid mucins. Cells near the terminations of the ducts of the bighorn sheep are the only elements to produce acid mucins in the duodenal glands of this species. The duodenal glands of the bison are unusual in that only the peripheral portions of individual glands produce acid mucins. The remainder of the glands elaborate neutral mucins. Morphological differences between the two regions were not observed. The duodenal glands of the mule deer secrete both acid and neutral mucins. The structural and histochemical observations appear unrelated to the diet of individual species.


Remarkable reinforcement of a supramolecular gel constructed by heteroditopic [18]crown-6-based molecular recognition.
The heteroditopic crown ether-based ligand 1 containing the diazafluorenylimino group as a binding site for the Zn(2+) and Cs(+) was synthesized. The ligand 1 can be gelated in DMSO/water with and without Cs(+) in the presence of the Zn(2+) ion. Interestingly, the remarkable gelation reinforcement of gel 1 occurred with Cs(+) in the presence of Zn(2+), which is due to the formation of a sandwich complex. According to DFT calculations, one Zn(2+) is bound to two diazafluorenylimino moieties in a tetrahedral structure. In addition, one Cs(+) ion is bound to two crown-rings. The Zn(2+)-diazafluorenylimino ligand gel without Cs(+) shows a spherical structure with 250-800 nm diameter, whereas the Zn(2+)-diazafluorenylimino-based ligand gel with Cs(+) shows a fiber structure with 60-70 nm diameter and several micrometers of lengths. The rheological properties of the Zn(2+)-diazafluorenylimino-based ligand gel were strongly dependent on the presence of Cs(+).


Effectiveness of a program on evidence-based dentistry in dental students.
Evidence-based dentistry (EBD) is an approach to oral healthcare by combining the best scientific evidence and clinical diagnostics, clinical expertise of the dentist, and the patient's treatment needs and preferences. The aim of the present study is to evaluate the effectiveness of an education program on EBD offered in a community-dentistry course in improving knowledge and attitudes of students in this regard. By a quasi-experimental study design, 64 senior dental students of Islamic Azad University of Khorasgan recruited in a controlled trial. All of the students were randomized as intervention (32) and control (32) groups. A course-based educational program on EBD was randomly assigned to one group. Actual knowledge, self-assessed knowledge, and attitudes, before and after education, were measured in both groups. A questionnaire consisted of 40 items developed by the researcher was used after confirming its validity and reliability. The difference between mean scores at two timelines were measured and compared in three fields by paired t-test and independent t-test analysis via SPSS version 20 software. While the mean scores of actual and self-assessed knowledge and attitude were not significantly different between two groups at the beginning of the program (P > 0.05), the mean scores of all fields in the intervention group were significantly more than those of the control group after education (P < 0.001). The effect size of intervention was 86%, 62%, and 57% in three fields, respectively. There was not a significant difference between mean scores of three fields in the control group, after the intervention. Due to the poor knowledge and attitudes of students and improved knowledge and attitudes of the intervention group after education, the education program seems to be effective. Durability of educational impact and evaluating evidence-based performance can be studied in the future.


Vehicular trauma triage by mechanism: avoidance of the unproductive evaluation.
An instrument was developed using routinely available field data to identify the sizable subgroup of stable vehicular trauma victims initially triaged to the trauma center by mechanism indicators alone who are in reality at minimal risk for serious injury. The six most common vehicular mechanism indicators seen at a level I trauma center were evaluated: rollover, head-on greater than 30 mph, intrusion, prolonged extrication, other death in same vehicle, and ejection. Review of 1235 consecutive trauma team activations yielded 349 victims with a qualifying vehicular mechanism. Outcome indicators were used to classify patients into two groups: Minor Injury (MI) and Severe Injury (SI). Nineteen common field data elements routinely reported on arrival by the regional Emergency Medical Service (EMS) personnel were then reviewed. Data patterns associated only with the MI group were sought. A checklist was developed for Mechanism vehicular trauma utilizing physiologic, anatomic, and neurologic elements. A single positive element would define trauma team activations. Retrospectively, use of this instrument would have excluded 56% of the MI group from unproductive trauma team referral, but nearly none of the SI group. We conclude that an identifiable subset of trauma patients referred by vehicular mechanism criteria alone could be safely evaluated on arrival in the emergency department as a form of secondary triage rather than by referral to the trauma team. The use of an appropriate exclusionary instrument can still preserve the sensitivity of trauma team activation for severely injured victims.


Microangiopathic haemolytic anaemia: the phenomenon of red cell adherence.
Examination by scanning electron microscopy of erythrocytes from three cases of microangiopathic haemolytic anaemia demonstrated the presence of adherent cells. Although in some cases this appeared to be due to a thin strand, presumably fibrin, between the erythrocytes, in most instances there was intimate contact and this was invariably associated with damage to the red cell surface membrane. It is considered that the adherence is predominantly due to altered physico-chemical properties of the surface membrane of the red blood cell and that further morphological abnormalities may result from the intravascular stresses to which the paired cells are subjected.


Changes in cervical length and the risk of preterm labor.
The purpose of this study was to assess the value of cervical length change as a predictor of preterm labor. We used an historic cohort of 154 women to compare change in cervical length and preterm birth. Independent variables included cervical length at the first sonogram, absolute change of cervical length, and change per unit time. Covariates included age, parity, and history of preterm birth. Eligible patients had 2 or more sonograms that included cervical length. The risk of preterm delivery increased as the length of the cervix declined, after an adjustment was made for the initial cervical length (P <.05). There were no significant interactions between initial length and the change of length; however, the highest rate of preterm deliveries occurred among women with a cervical length <3 cm at the first sonogram (23%). If the change in cervical length was expressed as a unit equal to a decline of 1 cm per month, the odds of giving birth to a preterm baby were 6.8-fold greater per unit change (P <.05). A cervical length of <3 cm before 16 weeks of gestation is associated strongly with preterm birth; independently of baseline length, more rapid shortening of the cervix increases the risk of preterm birth.


Estimation of unmeasured particulate air pollution data for an epidemiological study of daily respiratory morbidity.
The standard approach to government-mandated aerometric monitoring of airborne particulates across North America is to sample every sixth day year round. However, such data are inadequate for epidemiological studies which aim to examine daily time series relationships of particulate air pollution to respiratory health responses. The aim of the present study was to estimate missing daily particulate matter < or = 2.5 and < or = 10 microns in aerometric diameter (PM2.5 and PM10) and sulfate (SO4(2-) to a degree sufficiently accurate and reliable to allow the use of these estimates, along with the measured data, in an investigation of the relationship of air pollution to respiratory hospital admissions in Montreal during the 1980s. Prediction equations were developed for May through October periods using available daily levels of predictor variables which included: relative humidity-corrected light extinction coefficient (bext) derived from airport visual range sightings, coefficient of haze (COH), SO2, NOx, CO, O3, wind speed, wind direction, barometric pressure (BP), temperature, relative humidity, and total precipitation. Three fourths of the available gravimetric particulate data were used to develop prediction models, while the remaining fourth was used to test the reliability of the model (holdout data). All final models explained over 70% of the variability in the particulate air pollutants and were reliable when tested against the holdout data. The strongest (P < 0.001) and most consistent predictors were bext, COH, and O3 measured on the same day as the particulate, and BP lagged 1 day in the past. Other selected variables were same day NOx, BP, and minimum temperature. Although the present approach to the estimation of missing particulate air pollution may increase the level of exposure misclassification, it does allow for the use of existing network databases in epidemiological studies of daily air pollution health effects even though particulate data is only measured on certain days.


Anomalous front broadening during spontaneous imbibition in a matrix with elongated pores.
During spontaneous imbibition, a wetting liquid is drawn into a porous medium by capillary forces. In systems with comparable pore length and diameter, such as paper and sand, the front of the propagating liquid forms a continuous interface. Sections of this interface advance in a highly correlated manner due to an effective surface tension, which restricts front broadening. Here we investigate water imbibition in a nanoporous glass (Vycor) in which the pores are much longer than they are wide. In this case, no continuous liquid-vapor interface with coalesced menisci can form. Anomalously fast imbibition front roughening is experimentally observed by neutron imaging. We propose a theoretical pore-network model, whose structural details are adapted to the microscopic pore structure of Vycor glass and show that it displays the same large-scale roughening characteristics as observed in the experiment. The model predicts that menisci movements are uncorrelated, indicating that despite the connectivity of the network the smoothening effect of surface tension on the imbibition front roughening is negligible. These results suggest a new universality class of imbibition behavior, which is expected to occur in any matrix with elongated, interconnected pores of random radii.


Prolonged hospital stay and readmission rate in an enhanced recovery after surgery cohort undergoing colorectal cancer surgery.
The present database study aimed to identify patients with a longer postoperative length of stay (LOS) or patients readmitted and to characterize both groups based on perioperative factors. A retrospective review of the Danish Colorectal Cancer Group database and a local database was performed of all patients undergoing elective resection for colorectal cancer in a 25-month period. The primary outcome was the number of patients with a prolonged hospital stay (LOS ≥ 10 days after the primary operation) and readmissions within 30 days after discharge. A total of 372 patients with colon resection and 215 patients with rectal resection were included. Patients undergoing colonic resection had a rate of prolonged hospital stay of 10.6% and a readmission rate of 13.7%; prolonged hospital stay was significantly associated with age ≥ 76 years and those who underwent a conversion from a laparoscopic procedure. Patients undergoing rectal cancer resection had a rate of prolonged hospital stay of 17.7% and a readmission rate of 14.0%; Charlson comorbidity score (CCS) ≥ 2, total mesorectal excision (TME) and laparoscopic conversion were significantly associated with prolonged hospital stay, and American Society of Anesthesiologists (ASA) score ≥ 3, TME and a duration of surgery ≥ 300 min were significantly associated with readmission. In patients with colon cancer, older age and conversion to open surgery were associated with prolonged hospital stay. In patients with rectal cancer, CCS ≥ 2, TME and conversion were associated with prolonged hospital stay, and a preoperative ASA score ≥ 3, TME and a duration of surgery ≥ 300 min were associated with readmission.


Renal and bladder functions in patients after spinal cord injuries.
Thirty-eight patients with spinal cord lesions, 22 recent and 16 sustained more than three years previously, were investigated with intravenous pyelography, chrome EDTA clearance, cystoscopy and urodynamic studies. Analyses of bladder biopsies for tissue concentrations of nor-adrenaline and occurrence of acetylcholinesterase staining of nerves were also performed. Despite high incidence of fairly mild infections and trabeculation of the bladder, renal function was normal in most patients. Apart from incontinence, stone formation and recurrent urinary tract infections were the most common complications. The concentrations of noradrenaline and the numbers of acetylcholinesterase-stained nerves in bladder tissue specimens did not differ from control findings. The organization of the nerve structures did not vary with time after the injury, suggesting unchanged adrenergic and cholinergic innervation.


The medical consultation and the human person.
The consultation has been described as the most important part of Medicine. The Doctor-Patient Relationship is considered to depend on the trust of the patient in the doctor. This paper seeks to explore fundamental requirements of the consultation by exploring empathy, integrity, and the understanding of the human self, using concepts taken from Neuroscience, Group Analysis, Philosophy and Theology. It then introduces a plan for a study aimed at assessing the impact of a specific form of teaching consultation on the patient.


Cognitive constraints on how economic rewards affect cooperation.
Cooperation often fails to spread in proportion to its potential benefits. This phenomenon is captured by prisoner's dilemma games, in which cooperation rates appear to be determined by the distinctive structure of economic incentives (e.g., $3 for mutual cooperation vs. $5 for unilateral defection). Rather than comparing economic values of cooperating versus not ($3 vs. $5), we tested the hypothesis that players simply compare numeric values (3 vs. 5), such that subjective numbers (mental magnitudes) are logarithmically scaled. Supporting our hypothesis, increasing only numeric values of rewards (from $3 to 300 cent) increased cooperation (Study 1), whereas increasing economic values increased cooperation only when there were also numeric increases (Study 2). Thus, changing rewards from 3 cent to 300 cent increased cooperation rates, but an economically identical change from 3 cent to $3 elicited no gains. Finally, logarithmically scaled reward values predicted 97% of variation in cooperation, whereas the face value of economic rewards predicted none. We conclude that representations of numeric value constrain how economic rewards affect cooperation.


Can neutrophil-lymphocyte and platelet-lymphocyte ratios predict threatened abortion and early pregnancy loss?
An investigation of the importance of hematological inflammatory markers on the prognosis of first trimester pregnancies and their role in predicting threatened abortion and early pregnancy loss. This study was carried out in the Obstetrics and Gynecology Department of the Faculty of Medicine in our University between January 2018 and May 2019. Three-hundred individuals, 100 of them diagnosed with early pregnancy loss (EPL), 100 diagnosed with threatened abortion (TA) and 100 healthy control patients (HC), participated in the study. There were no statistically significant differences in terms of hemoglobin, platelet, neutrophil count and NLR between the three groups. The RBC counts were significantly lower in EPL and TA compared to HC. Similarly, it was determined that the MPV value was significantly lower in EPL compared to HC. On the other hand, there was no difference in MPV between TA and HC. The PLR was higher in EPL and TA. MPV, RBCs and PLR values were strongly associated with first-trimester miscarriage. These economical and easily measurable platelet indices can be used to predict fetal losses.


Examining Cognitive Status of Elderly Iranians: Farsi Version of the Modified Mini-Mental State Examination.
The Modified Mini-Mental State Examination (3MS) is an expanded and modified version of the Mini-Mental State Examination (MMSE). Research demonstrates that the reliability, validity, specificity, and sensitivity of the 3MS are superior to that of the MMSE in detecting cognitive impairment. The Farsi version of the 3MS (F-3MS) was examined as a screening tool for dementia among elderly Iranians. The F-3MS and the Clock Drawing Test (CDT) were administered to 58 patients with dementia and 145 control subjects with normal cognition, aged 60 to 85 years. The difference between groups on the mean total scores of the F-3MS was statistically significant (dementia = 60.65 ± 9.89, control = 80.73 ± 8.26; df = 201, t = 14.75, p < .001). The receiver-operating characteristic curve showed 78 as the optimal cutoff point for detecting dementia, with a sensitivity of 98% and specificity of 81%. Interrater reliability was high (n = 50, r = .91, p < .001), as were test-retest reliability (n = 50, r = .89, p < .001) and internal consistency (a = .85). The F-3MS correlated strongly with the CDT, supporting convergent validity of the F-3MS. The F-3MS can be used as a valid and reliable measure for dementia screening among elderly Iranians.


History of gymnemic acid, a molecule that does not exist. .
In the literature there are hundreds of articles, the first dating back to 1866 and the last to 2014, on gymnemic acid, isolated from Gymnnema sylvestre, from its isolation to the determination of its biological activities. Gymnemic acid has a CAS number but its structure is not specified. Studies during the second half of the 1970s clearly demonstrated that what was being referred to as gymnemic acid is actually a very complex mixture of dozens of substances, belonging to different classes of natural compounds. This plant, whose infusions or complex mixtures of its metabolites are the basis for many formulas sold in pharmacies and by herbalists, has anti-diabetic and slimming effects. It is certainly misleading to talk about gymnemic acid as a specific molecule. There may be doubts about the exact composition of the products, and consequently about their origin and the claimed effects.


DDA3 and Mdp3 modulate Kif2a recruitment onto the mitotic spindle to control minus-end spindle dynamics.
Active turnover of spindle microtubules (MTs) for the formation of a bi-orientated spindle, chromosome congression and proper chromosome segregation is regulated by MT depolymerases such as the kinesin-13 family and the plus-end-tracking proteins (+TIPs). However, the control mechanisms underlying the spindle MT dynamics that are responsible for poleward flux at the minus end of MTs are poorly understood. Here, we show that Mdp3 (also known as MAP7D3) forms a complex with DDA3 (also known as PSRC1) and controls spindle dynamics at the minus end of MTs by inhibiting DDA3-mediated Kif2a recruitment to the spindle. Aberrant Kif2a activity at the minus end of spindle MTs in Mdp3-depleted cells decreased spindle stability and resulted in unaligned chromosomes in metaphase, lagging chromosomes in anaphase, and chromosome bridges in telophase and cytokinesis. Although they play opposing roles in minus-end MT dynamics, acting as an MT destabilizer and an MT stabilizer, respectively, DDA3 and Mdp3 did not affect the localization of each other. Thus, the DDA3 complex orchestrates MT dynamics at the MT minus end by fine-tuning the recruitment of Kif2a to regulate minus-end MT dynamics and poleward MT flux at the mitotic spindle.


Consequences of nonlocal connections in networks of chaotic maps under threshold activated coupling.
We study the effects of random nonlocal connections on networks of chaotic maps under threshold activated coupling. In threshold regimes where a large number of unsynchronized attractors occur under regular connections, we show how nonlocal rewirings yield synchronized networks. However, the dependence of the synchronized fraction on the fraction of randomized nonlocal links is typically nonmonotonic here. Further, the mean time to reach synchronization with respect to the fraction of rewiring also indicates an optimum degree of nonlocality for which synchronization is most efficiently achieved.


Phase-polarization parallax barriers for an autostereo/stereo/monoscopic display with full-screen resolution at each operation mode.
It is attractive to have a three-mode flat-panel 3D display capable of working in autostereoscopic, stereoscopic-with-passive-glasses, and monoscopic modes and providing full-screen resolution of images at each mode. The concept of autostereoscopic displays simultaneously reproducing two image elements in each display pixel based on information-dependent polarization coding and subsequent decoding was recently proposed. Such a concept allows full-screen resolution in each image view and flickerless 3D images to be observed even at a 60-Hz frame rate. The essential problem of such display implementation is to create the suitable structure of the phase-polarization parallax barrier (PPPB) capable of working properly at a variable polarization state of input light. This paper presents the results of theoretical research of an electrically switchable liquid crystal (LC) PPPB. The Jones matrix notation of the required performance function of the LC PPPB is found. The results of computer modeling of achromatic characteristics of suitable LC structures are discussed to determine the optimum structures for PPPB. The proposed layout of three-mode 3D display with LC PPPB allows it to go from autostereoscopic mode to "stereoscopic-with-passive-glasses" mode and backward by electrical switching the LC PPPB in combination with removing/inserting the output polaroid film.


[Dynamic observation IgG and IgM antibodies in patients with severe acute respiratory syndrome].
To observe IgG and IgM antibodies in patients with severe acute respiratory syndrome (SARS) and to explore their significance. IgG and IgM antibodies were detected in SARS Patients in the first, recovery and follow-up stages, the front healthy doctors and nurses and healthy volunteers with indirect enzyme-linked immunoadsorbent assay. The positive ratio of IgG was higher than that of IgM in SARS patients during the first stage. During the recovery, follow-up stages and in the front healthy crowd, the positive ratios of IgG were all higher than those of IgM. The changeable tendency SARS antibody is more different than that of other infectious diseases. This tendency can be used as a indicator for epidemiological study and serum diagnose.


Stable Encapsulated Air Nanobubbles in Water.
The dispersion into water of nanocapsules bearing a highly hydrophobic fluorinated internal lining yielded encapsulated air nanobubbles. These bubbles, like their micrometer-sized counterparts (microbubbles), effectively reflected ultrasound. More importantly, the nanobubbles survived under ultrasonication 100-times longer than a commercial microbubble sample that is currently in clinical use. We justify this unprecedented stability theoretically. These nanobubbles, owing to their small size and potential ability to permeate the capillary networks of tissues, may expand the applications of microbubbles in diagnostic ultrasonography and find new applications in ultrasound-regulated drug delivery.


Getting home on time: predicting timely permanence for young children.
The timelines of the Adoption and Safe Families Act (ASFA) (P.L. 105-89) require increased attention to the timing of permanent placement, regardless of the type of placement outcome. This study examines the multivariate predictors of timely permanence for children served by Colorado's Expedited Permanency Planning (EPP) project. EPP has used an intensive concurrent planning model aimed at reaching permanency within 12 months of initial placement for children aged 6 and younger. The EPP requirement that children be living in the permanent home by 12 months postplacement is more stringent than the technical ASFA requirements. This article uses qualitative interviews with child welfare and court personnel to identify critical barriers to and supports for effective permanency planning.


Clinical and demographic predictors of loss of pulmonary function in systemic sclerosis.
The course of functional pulmonary involvement in systemic sclerosis remains controversial; and it is not known if specific clinical or demographic features are predictive of subsequent changes in pulmonary function. To address these questions, we conducted a non-concurrent prospective study of serial pulmonary function in 24 patients with systemic sclerosis unselected for pulmonary involvement over a mean follow-up interval of 59.7 months. Initial values for the entire group demonstrated a mild restrictive defect with a mild reduction in gas exchange. Although a restrictive pattern was most common, normal and obstructed pulmonary function were seen. Mean rates of change of FVC, TLC, FEV1/FVC, and Dco for the entire group were not different from normal, but substantial variability in the course of pulmonary functional involvement was seen among individuals. Changes in gas transfer, lung volumes, and airflow can occur independent of each other. Rates of change in pulmonary function were not predicted by initial pulmonary function, race, sex, duration of disease, cardiac involvement, roentgenographic fibrosis, or regression of skin disease. Patients with severe Raynaud' phenomenon exhibited the greatest fall in Dco over time, suggesting an association between peripheral and pulmonary vascular involvement. A correlation between exertional dyspnea and rapid loss of Dco was noted. Former smokers had significantly greater rates of loss of FVC and Dco than either non-smokers or current smokers, suggesting that cessation of smoking was a response to rapidly declining function in a subgroup of susceptible smokers. We detected a wide spectrum of severity of pulmonary prognosis in systemic sclerosis, ranging from normal pulmonary function to rapidly progressive disease leading to death. This study indicates that patients with prolonged survival do not necessarily have a rapidly progressive pulmonary component, but those with severe Raynaud's phenomenon and susceptible smokers are at very high risk for rapid deterioration of pulmonary function.


Interaction of Vicia graminea anti-N lectin with cell surface glycoproteins from erythrocytes with rare blood group antigens.
The erythrocyte receptors for Vicia graminea (Vg) anti-N lectin have been investigated after 125I-labelling of the purified lectin and binding to membrane components separated by dodecyl sulphate polyacrylamide gel electrophoresis. GP alpha (synonym glycophorin A or MN glycoprotein) and GP delta (synonym glycophorin B or Ss glycoprotein) are the main Vg receptors of native human blood group NN and MN erythrocytes whereas Vg lectin only binds to GP delta from MM red cells. The glycoprotein of 28 kDa present in Mi III erythrocytes (a presumed variant of GP delta) carries Vg receptors. Both binding studies and agglutination experiments with this lectin suggest that the delta Mi III gene might produce more glycoprotein molecules than the normal delta gene. Binding of Vg lectin to hybrid glycoproteins [from Mi V, St(a+) and Dantu (+) donors] produced by unequal crossing-over between alpha and delta genes, may occur if the molecules exhibit N activity. The lectin does not bind to sialic acid- and galactose-deficient glycoproteins from Tn erythrocytes and no binding could be detected in the region of GP delta of erythrocytes from S-s-U-individuals. Addition of N-acetylgalactosamine residues to the alkali-labile oligosaccharides attached to GP alpha and GP delta, as found in Cad erythrocytes, decrease the binding capacity for Vg lectin. Finally the absence of Vg lectin binding sites on native GP alpha molecule from MgMg and McM erythrocytes, which carry well defined variants of this glycoprotein, supports the view that the binding site of the lectin on native glycoproteins is located at the N-terminal end of glycoprotein (GP alpha and GP delta) with N specificity (N-terminus = Leu).


Continuous subcutaneous infusion of lidocaine for persistent hiccup in advanced cancer.
Persistent hiccup can cause anorexia, weight loss, disabling sleep deprivation, anxiety, and depression. Therefore, relief of persistent hiccup is important for advanced cancer patients and their family. Most reports on this condition are case series reports advocating the use of baclofen, haloperidol, gabapentin, and midazolam. However, these medications are occasionally ineffective or accompanied by intolerable side effects. The sodium channel blocker lidocaine has been shown to be effective in treating a variety of disorders thought to involve neuropathic mechanisms. Intravenous administration of lidocaine is common but efficacy has also been reported for subcutaneous infusion. In advanced cancer patients, subcutaneous infusion is easy, advantageous, and accompanied by less discomfort. We report a case of severe and sustained hiccup caused by gastric cancer that was successfully treated with a continuous subcutaneous infusion of lidocaine (480 mg (24 ml)/day) without severe side effects.


Intrasexual Competition and Height in Adolescents and Adults.
Intrasexual competition can be defined as the struggle between members of one sex to increase their access to members of the other sex as sexual partners. In our species, height is a sexually dimorphic trait probably involved in both intrasexual and intersexual selective processes. In the present research, we examined the relationship between height and individual differences in intrasexual competitiveness (i.e., the tendency to view same-sex interactions in general in competitive terms) in two populations of adolescents and adults of both sexes in Chile. According to our first prediction, among both adolescent and adult men, height was negatively associated with intrasexual competitiveness. In contrast, among women, height was not linearly nor quadratically related with intrasexual competitiveness as previously reported. Finally, adolescent men and women showed increased levels of intrasexual competitiveness compared to adult same-sex counterparts. Our results suggest that height is a relevant trait in mating competition among men. The lack of relationship between height and intrasexual competitiveness in women may suggest that the role of height in women mating competition may be more complex and mediated by other variables.


Total serum IgE level influences oral food challenge tests for IgE-mediated food allergies.
Probability curves predicting oral food challenge test (OFC) results based on specific IgE levels are widely used to prevent serious allergic reactions. Although several confounding factors are known to affect probability curves, the main factors that affect OFC outcomes are currently unclear. We hypothesized that an increased total IgE level would reduce allergic reactivity. Medical records of 337 and 266 patients who underwent OFCs for 3.5 g boiled hen's egg white and 3.1 ml raw cow's milk, respectively, were examined retrospectively. We subdivided the patients into three groups based on total IgE levels and age by percentile (<25th, 25-75th, and >75th percentiles), and logistic regression analyses were performed on each group. Patients with higher total IgE levels were significantly less responsive. In addition, age did not significantly affect the OFC results. Therefore, total IgE levels should be taken into account when predicting OFC results based on food-specific IgE levels.


Perceptions, Characteristics, and Behaviors of Cigarette and Electronic Cigarette Use among Pregnant Smokers.
Smoking during pregnancy is a primary risk factor for adverse perinatal outcomes. Although electronic cigarette (e-cigarette) use has increased, reasons for and behaviors of use are not fully understood. The purpose of this study, composed exclusively of pregnant current smokers, was to describe perceptions of health risks associated with e-cigarette use among pregnant women, describe the use patterns of pregnant dual users (defined as those who simultaneously use conventional/combustible cigarettes and e-cigarettes), and examine smoking-related behaviors between conventional-only (defined as those smoking combustible cigarettes but not e-cigarettes) and dual users. Cross-sectional data from a larger study of pregnant conventional-only and dual users were analyzed. A brief survey measured perceptions of prenatal e-cigarette use and smoking behaviors. Analysis included descriptive statistics, bivariate analysis, and logistic and linear regression analysis. Among 176 pregnant smokers (38% dual users), more than one-half of participants believed e-cigarettes were harmful to women (56%) and posed harm to the fetus (53%). Among dual users, 41% used their e-cigarette daily, on average eight times per day. Eleven percent of dual users smoked a pack of cigarettes per day, compared with 5% of conventional-only smokers, and dual users scored significantly higher (p = .026) on the Penn State Cigarette Dependence Index. The most common e-cigarette liquid flavor was fruit (64%), and the most frequently reported e-cigarette nicotine concentration was 1-6 mg. Characterizing perceptions and behaviors of e-cigarette use during pregnancy is foundational for future research to explore the association between product use and maternal and infant outcomes.


Enhanced production of extracellular inulinase by the yeast Kluyveromyces marxianus in xylose catabolic state.
The production of extracellular proteins by the thermotolerant yeast Kluyveromyces marxianus, which utilizes various sugars, was investigated using media containing sugars such as glucose, galactose, and xylose. SDS-PAGE analysis of culture supernatants revealed abundant production of an extracellular protein when cells were grown in xylose medium. The N-terminal sequence of the extracellular protein was identical to a part of the inulinase encoded by INU1 in the genome. Inulinase is an enzyme hydrolyzing β-2,1-fructosyl bond in inulin and sucrose and is not required for xylose assimilation. Disruption of INU1 in the strain DMKU 3-1042 lost the production of the extracellular protein and resulted in growth defect in sucrose and inulin media, indicating that the extracellular protein was inulinase (sucrase). In addition, six K. marxianus strains among the 16 strains that were analyzed produced more inulinase in xylose medium than in glucose medium. However, expression analysis indicated that the INU1 promoter activity was lower in the xylose medium than in the glucose medium, suggesting that enhanced production of inulinase is controlled in a post-transcriptional manner. The production of inulinase was also higher in cultures with more agitation, suggesting that oxygen supply affects the production of inulinase. Taken together, these results suggest that both xylose and oxygen supply shift cellular metabolism to enhance the production of extracellular inulinase.


[Temporary vascular access in dialysed patients].
Presently, large venous vessel cannulation is the only procedure for attaining immediate dialysis access. As another option, vascular access may be a method for guaranteeing drug administration or parenteral feeding. The aim of the following paper was to evaluate the course of central venous catheter implantation and associated complications. The study included 235 patients (120 male, 115 female) between the ages of 24 and 87 years, treated at the Nephrology Department of the Jagiellonian University in Cracow from January, 1997 to March, 2001. Choice of cannulation location was as follows: subclavian vein--113 cases; internal jugular vein--107 cases; femoral vein--15 cases. In 223 patients, implanted catheters determined temporary access for hemo-dialysis or other extracorporeal circulation, where in 12 cases they determined location for drug administration. The following complications were observed during cannulation: accidental artery puncture--20 cases; inability to implant cannulation probe and puncture location change--16; inability to localize vessel at the first attempt of puncture--12; hematoma at puncture location--8; cephalad probe misplacement--6; bleeding at puncture site--5; catheter occlusion--25; inflammation at catheter exit site--14; catheter bending--10; vessel wall adherence of catheter arterial lumen--8; catheter removal by patient--8; damage of Luer ending--5; bacteremia confirmed by bacterial culture--4 (including 2 cases of sepsis); subcutaneous emphysema--1 case. Cannulation of large venous vessels is a safe method, associated with a small number of complications (23%), where the majority are of mild character (85%). In our material, infectious complications comprised only a low percentage (7.6%) presenting with an asymptomatic or mild course.


Hair loss in women.
Hair loss is a common cause of morbidity for many women. As a key member of the woman's health care team, the obstetrician/gynecologist may be the first person to evaluate the complaint of hair loss. Common types of nonscarring hair loss, including female pattern hair loss and telogen effluvium, may be diagnosed and managed by the obstetrician/gynecologist. A systematic approach to diagnosis and management of these common forms of hair loss is presented.


A patient with hepatocellular carcinoma who developed invasive pulmonary aspergillosis after corticosteroid treatment.
Lung or head and neck cancer have been indicated as solid cancers associated with invasive pulmonary aspergillosis (IPA), but the relationship with hepatocellular carcinoma (HCC) is unknown. We report a case of HCC in which the presence of cirrhosis and corticosteroid administration may have caused the development of IPA.


Effects of lactitol-oligosaccharides on calcium and magnesium absorption in rats.
Lactitol-oligosaccharide (LO) was prepared from lactitol by transglycosylation reaction with Aspergillus oryzae beta-galactosidase. LO is resistant to metabolism in the small intestine but not in the large intestine. The effects of LO, lactose (Lac), lactitol (Lacol) and galactooligosaccharide (GL) on calcium and magnesium absorption were determined by feeding 8-week-old Sprague-Dawley male rats diets containing 5% of the above carbohydrates for two weeks. The results obtained were as follows. 1) A significant increase of calcium absorption was observed in the LO diet. 2) A significant increase of magnesium absorption was observed in the LO, GL and Lacol diets. 3) The concentration of total volatile fatty acids (VFA) in the cecal contents increased significantly in the LO, GL and Lacol diets. The main constituent of VFA in the cecal contents was found to be acetic acid. 4) The correlations between calcium and magnesium absorption ratios and total VFA concentration in the cecum were found to be significantly related. These findings suggest that LO is metabolized to VFA, among which acetic acid concentration seems to have the most stimulatory effect on the absorption of calcium.


Comorbid bipolar affective disorder and obsessive compulsive disorder in childhood: a case study and brief review.
Obsessive compulsive disorder and bipolar affective disorder in the pediatric population show a bidirectional overlap. Few studies that have addressed this issue show that the prevalence of obsessive compulsive disorder in bipolar affective disorder patients ranges from 0 to 54%, and 1.85 to 36% of the obsessive compulsive disorder patients have a comorbid bipolar affective disorder. We report a case of a patient with an onset of obsessive compulsive disorder at two-and-a-half years of age, who developed mania after exposure to escitalopram. We suggest that in pediatric obsessive compulsive disorder cases, antidepressants be used with caution, especially in cases with a positive family history of bipolar affective disorder.


Structure and conformational analysis of spiroketals from 6-O-methyl-9(E)-hydroxyiminoerythronolide A.
Three novel spiroketals were prepared by a one-pot transformation of 6-O-methyl-9(E)-hydroxyiminoerythronolide A. We present the formation of a [4.5]spiroketal moiety within the macrolide lactone ring, but also the unexpected formation of a 10-C=11-C double bond and spontaneous change of stereochemistry at position 8-C. As a result, a thermodynamically stable structure was obtained. The structures of two new diastereomeric, unsaturated spiroketals, their configurations and conformations, were determined by means of NMR spectroscopy and molecular modelling. The reaction kinetics and mechanistic aspects of this transformation are discussed. These rearrangements provide a facile synthesis of novel macrolide scaffolds.


Protein preservation and ruminal degradation of ensiled forage treated with heat, formic acid, ammonia, or microbial inoculant.
The objectives of this study were to determine whether treatment of forage with heat would reduce proteolysis during subsequent fermentation. In Experiment 1, direct-cut barley forage and alfalfa were untreated, microwaved, or steamed and then ensiled in laboratory silos as wilted forages. Silages of microwaved or steamed forage showed a marked increase in N bound to neutral detergent fiber and in the recovery of protein; however, alfalfa silages also had high pH values and concentrations of butyric acid. In Experiment 2, steam heating was compared with formic acid and NH3 treatments for the prevention of proteolysis in alfalfa silages. Silage of steamed alfalfa had a greater amount of N bound to neutral detergent fiber and greater recovery of protein than did control silage or silages of forage treated with formic acid or NH3. Silage of steamed forage had lower pH values than did silages of wilted, direct-cut, or control forage. Microbial innoculant added to steamed forage increased the recovery of protein. Silage of steamed forage had less aerobic stability than did silage of direct-cut forage. Ruminal degradability of crude protein (CP) and organic matter of silage from both experiments was evaluated. Degradability of CP was 8 to 26 percentage units lower in silages of microwaved or steamed forage in Experiment 1 than in silage of unheated forage because of slower degradation rates, but all had similar undegraded CP after incubation for 72 h. In Experiment 2, wilting, steam, formic acid, and NH3 treatments affected CP degradability similarly, but CP degradability was decreased when compared with silage of direct-cut forage without treatment.


Radiative transfer equation for predicting light propagation in biological media: comparison of a modified finite volume method, the Monte Carlo technique, and an exact analytical solution.
We examine the accuracy of a modified finite volume method compared to analytical and Monte Carlo solutions for solving the radiative transfer equation. The model is used for predicting light propagation within a two-dimensional absorbing and highly forward-scattering medium such as biological tissue subjected to a collimated light beam. Numerical simulations for the spatially resolved reflectance and transmittance are presented considering refractive index mismatch with Fresnel reflection at the interface, homogeneous and two-layered media. Time-dependent as well as steady-state cases are considered. In the steady state, it is found that the modified finite volume method is in good agreement with the other two methods. The relative differences between the solutions are found to decrease with spatial mesh refinement applied for the modified finite volume method obtaining <2.4%. In the time domain, the fourth-order Runge-Kutta method is used for the time semi-discretization of the radiative transfer equation. An agreement among the modified finite volume method, Runge-Kutta method, and Monte Carlo solutions are shown, but with relative differences higher than in the steady state.


Working with GM vaccines: engaging the public.
The UK Veterinary Vaccinology Network was among the sponsors of this year's Cheltenham Science Festival, which took place from June 7 to 12. During the festival, Adrian Hill and Andrew Pollard, of the Jenner Institute, and Bryan Charleston, of the Pirbright Institute, represented the network and discussed the development of genetically modified vaccines and the issues surrounding them in animal and human health. Madeleine Clark sums up their presentation.


Transportation vulnerability as a barrier to service utilization for HIV-positive individuals.
Research suggests that transportation vulnerability can negatively impact adherence to HIV-related medical treatment. Moreover, transportation can be a barrier to accessing ancillary services which can increase positive health outcomes for HIV-positive individuals. This study examines transportation vulnerability and its impact on HIV-related health and ancillary service utilization in the Mid-South Region. Focus groups and interviews were conducted with service providers and HIV-positive individuals, and survey data were collected from HIV-positive individuals (N=309) using the five A's of access to frame transportation vulnerability: availability, accessibility, accommodation, affordability, and acceptability. Study results indicate that transportation vulnerability can present significant barriers to service utilization for HIV-positive individuals, including insufficient transportation infrastructure, incompatible fit between transportation and health systems, and insensitivity to privacy issues. One consequence of transportation vulnerability is reliance upon weaving together multiple modes of transport to access care and ancillary services, creating additional barriers to service utilization and medical adherence. The research team recommends more investment in public transit systems, expanded services, and innovative approaches to solving procedural problems.