Solitary drain-site recurrence after lumpectomy for breast cancer.
Locoregional recurrence after breast conservative surgery is not a rare event. However, a metastatic nodule solely at the surgical drain site seems to be extremely unusual. In this report, we present a patient who received a lumpectomy for breast cancer but a metastatic nodule developed at the drain site more than two years after her surgery.


Extraordinary cluster formation and intramolecular ligand-ligand interactions in cyanoacetylene [corrected] mediated by Mg+*: implications for the atmospheric chemistry of titan and for circumstellar chemistry.
Experimental results are reported that track the kinetics of gas-phase reactions initiated by Mg+*, (c-C5H5)Mg+ and (c-C5H5)2Mg+* in hydrogen cyanide and cyanoacetylene. The experiments were performed with a selected-ion flow tube (SIFT) tandem mass spectrometer at a helium buffer-gas pressure of 0.35 +/- 0.01 Torr and at 294 +/- 3 K. The observed chemistries of Mg+* and (c-C5H5)Mg+ are dominated by sequential ligation, while that of (c-C5H5)2Mg+* is by ligand switching. The rate-coefficient measurements for sequential addition of cyanoacetylene to Mg+* indicate an extraordinary pattern in alternating chemical reactivity while multiple-collision induced dissociation experiments revealed an extraordinary stability for the Mg(HC3N)4+* cluster ion. Molecular orbital calculations with density functional theory (DFT) at the B3LYP level, Hartree-Fock (HF) and second-order Mphiller-Plesset (MP2) levels, all performed with a 6-31+G(d) basis set, have been used to calculate structures and energies for the observed Mg(HC3N)1-4(+)* cations. These calculations indicate that the path of formation of Mg(HC3N)4+* involves ligand-ligand interactions leading to two cyclic (HC3N)2 ligands which then interact to form 2,4,6,8-tetracyanosemibullvalene-Mg+ or 1,2,5,6-tetracyano-1,3,5,7-cyclooctatetraene-Mg+ cations. A case is made for the formation of similar complex organomagnesium ions in the upper atmosphere of Titan where subsequent electron-ion recombination may produce cyano derivatives of large unsaturated hydrocarbons. In contrast, circumstellar environments with their much higher relative content of free electrons are less likely to give rise to such chemistry.


Structural and Solar Cell Properties of a Ag-Containing Cu2ZnSnS4 Thin Film Derived from Spray Pyrolysis.
A silver (Ag)-incorporated kesterite Cu2ZnSnS4 (CZTS) thin film was fabricated by a facile spray pyrolysis method. Crystallographic analyses indicated successful incorporation of various amounts of Ag up to a Ag/(Ag + Cu) ratio of ca. 0.1 into the crystal lattice of CZTS in a homogeneous manner without formation of other impurity compounds. From the results of morphological investigations, Ag-incorporated films had larger crystal grains than the CZTS film. The sample with a relatively low Ag content (Ag/(Ag + Cu) of ca. 0.02) had a compact morphology without appreciable voids and pinholes. However, an increase in the Ag content in the CZTS film (Ag/(Ag + Cu) ca. 0.10) induced the formation of a large number of pinholes. As can be expected from these morphological properties, the best sunlight conversion efficiency was obtained by the solar cell based on the film with Ag/(Ag + Cu) of ca. 0.02. Electrostructural analyses of the devices suggested that the Ag-incorporated film in the device achieved reduction in the amounts of unfavorable copper on zinc antisite defects compared to the bare CZTS film. Moreover, the use of a Ag-incorporated film improved band alignment at the CdS(buffer)-CZTS interface. These alterations should also contribute to enhancement of device properties.


Endothelium-fibrinolysis system interaction.
The role of urokinase-type plasminogen activator (u-PA) in capillary growth was investigated using cultured bovine endothelial cells (BCE) on type I collagen gels and analyzed by morphometry for quantitative assessment of angiogenesis in vitro. BCE migrated into the gel matrix and formed capillary-like networks. The morphometrical analyses by measuring the length of tube formation enabled us to evaluate the effects of fibrinolytic proteases and several reagents. The addition of plasminogen up to 25 micrograms/ml to the gels significantly increased the extent of tube formation of BCE in a dose-dependent manner. Basic fibroblast growth factor (10 ng/ml) increased tube formation only in the presence of plasminogen. These enhancing effects on angiogenesis appeared to be related to the activation of fibrinolysis by u-PA derived from BCE, because they were suppressed by the addition of anti-u-PA IgG and anti-plasmin reagents such as aprotinin and alpha 2 anti-plasmin. Transforming growth factor beta also enhanced tube formation of BCE, but tumor necrosis factor alpha and interleukin-1 suppressed the tube formation. The quantitative assay of angiogenesis may be useful for clarifying the mechanism of neovascularization under pathological conditions.


Requirements for induction of specific suppressor T cells and detection of their H-2 antigen-binding receptors by fractionation on target cell monolayers.
The MC-resistant specific suppressor T cells that inhibit DNA synthesis and CTL generation in MLC were induced in vivo by gamma-irradiated allogeneic lymphoid cells in a large dose. MLRs were inhibited only slightly when triggered by third-party cells, even neighbouring with the corresponding stimulators. Unlike the irradiated cells, intact allogeneic lymphoid cells induced a mixture of macrophage-like and T-cell suppressors with a pronounced non-specific component of the action. Syngeneic cells induced low active non-specific suppressors of macrophage type only. The suppression was not due to a cytotoxic effect, since specific T suppressors differed from CTL by conditions of induction and high sensitivity to gamma-irradiation and from CTL precursors by high sensitivity to CY and HC. The specific T-suppressors could be selectively removed by adherence to a macrophage monolayer of the corresponding donor. The subsequent elution of adherent lymphocytes with pronase resulted in enrichment of specific T suppressors by a factor of 30 and 2.6, as judged by reduction in the number of lymphocytes required for 50% inhibition of DNA synthesis and 33% inhibition of CTL generation, respectively. The high specificity of this enrichment is shown by using both syngeneic monolayers for fractionation and third-party stimulators in MLR for testing and by disappearance of slight non-specific suppression caused by non-fractionated suppression. Complete inactivation of the eluted suppressors with anti-Thy-1.2 and anti-T antibodies, their resistance to anti-Mls antibodies, carrageenin, and carbonyl iron, together with the data of autoradiographic study and total DNA synthesis in the population indicate that the eluted highly specific suppressors represent mainly DNA-synthesizing large and medium T lymphocytes.


Evaluation of Esophageal Motor Function With High-resolution Manometry.
For several decades esophageal manometry has been the test of choice to evaluate disorders of esophageal motor function. The recent introduction of high-resolution manometry for the study of esophageal motor function simplified performance of esophageal manometry, and revealed previously unidentified patterns of normal and abnormal esophageal motor function. Presentation of pressure data as color contour plots or esophageal pressure topography led to the development of new tools for analyzing and classifying esophageal motor patterns. The current standard and still developing approach to do this is the Chicago classification. While this methodical approach is improving our diagnosis of esophageal motor disorders, it currently does not address all motor abnormalities. We will explore the Chicago classification and disorders that it does not address.


HIV-TB Cross-referral and Collaborative Strategy: 8 Years of Our Experience from An Urban Health Centre in North India.
Human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics continue to fuel each other and with dual infections with these two deadly diseases on the rise, it becomes imperative to devise effective HIV-TB collaborative strategies. The present study was designed to evaluate the existing HIV-TB cross-referral mechanism at an urban health centre; to determine HIV sero-prevalence among pulmonary TB patients referred from chest clinic to the integrated counselling and testing centre (ICTC); and to evaluate the TB suspects referred from ICTC to the chest clinic for a possible TB aetiology. The present study was a retrospective analysis of HIV-TB cross-referrals whereby a line list of all the patients referred under this strategy from January 2006 to December 2013 was retrieved and analysed. A total of 3726 TB cases were referred to the ICTC and 641 TB suspects were identified by ICTC counsellors and referred to the chest clinic during this period. HIV sero-prevalence among TB patients was 2.8% (106 of 3726) and TB prevalence among HIV sero-positive and sero-negative TB suspects was 9.3% (10/108) and 4.3% (9/211), respectively (p=0.07). HIV prevalence was found to be significantly higher among male (n=2024) than among female (n=1702) TB patients (4.4% versus 0.9%; p<0.0001). Only 319 of 641 (49.8%) ICTC patients referred to the chest clinic reached there. Our study highlights the strong need to scale up the integration and partnership between HIV and TB programmes for better and integrated diagnosis and care of HIV-TB co-infected patients.


Bilateral frosted branch angiitis as the presenting sign of antiphospholipid antibody syndrome.
"Frosted branch retinal angiitis" is an encompassing term for a rare, typically bilateral diffuse retinal periphlebitis that may occur in a number of varying conditions. To our knowledge, we report the first case of frosted branch angiitis as the presenting sign of antiphospholipid antibody syndrome in a 28-year-old woman. This study is a retrospective case report and literature review. Serial fundus photos, fluorescein angiogram, and ocular coherence tomography taken were before and after treatment, showing resolution of diffuse retinal perivascular sheathing and macular edema along with marked improvement in visual acuity 4 months after the treatment with corticosteroids. Frosted branch angiitis can be seen in association with antiphospholipid antibody syndrome. Prompt recognition and treatment with corticosteroids may result in good visual prognosis, and long-term immunosuppression and additional anticoagulation may be beneficial to prevent recurrence.


Age at natural menopause and cause-specific mortality.
Several studies have suggested that a young age at menopause may be associated with increased risk of all-cause mortality. Few studies have examined the influence of age at menopause on specific causes of death other than coronary heart disease. Data from a prospective cohort study of US adults were used to examine the relation between age at natural menopause and all-cause and cause-specific mortality among women who never used hormone replacement therapy, who never smoked, and who experienced natural menopause between the ages of 40 and 54 years. After 20 years of follow-up between 1982 and 2002, 23,067 deaths had occurred among 68,154 women. Results from Cox proportional hazards models showed that all-cause mortality rates were higher among women who reported that menopause occurred at age 40-44 years compared with women who reported that menopause occurred at age 50-54 years (rate ratio (RR) = 1.04, 95% confidence interval (CI): 1.00, 1.08). This increased risk was largely due to higher mortality rates from coronary heart disease (RR = 1.09, 95% CI: 1.00, 1.18), respiratory disease (RR = 1.19, 95% CI: 1.02, 1.39), genitourinary disease (RR = 1.39, 95% CI: 1.07, 1.82), and external causes (RR = 1.56, 95% CI: 1.21, 2.02). These findings suggest that mortality from other diseases, as well as coronary heart disease, may contribute to the increased mortality associated with a younger age at menopause.


The axolotl genome and the evolution of key tissue formation regulators.
Salamanders serve as important tetrapod models for developmental, regeneration and evolutionary studies. An extensive molecular toolkit makes the Mexican axolotl (Ambystoma mexicanum) a key representative salamander for molecular investigations. Here we report the sequencing and assembly of the 32-gigabase-pair axolotl genome using an approach that combined long-read sequencing, optical mapping and development of a new genome assembler (MARVEL). We observed a size expansion of introns and intergenic regions, largely attributable to multiplication of long terminal repeat retroelements. We provide evidence that intron size in developmental genes is under constraint and that species-restricted genes may contribute to limb regeneration. The axolotl genome assembly does not contain the essential developmental gene Pax3. However, mutation of the axolotl Pax3 paralogue Pax7 resulted in an axolotl phenotype that was similar to those seen in Pax3-/- and Pax7-/- mutant mice. The axolotl genome provides a rich biological resource for developmental and evolutionary studies.


Haematological and Immunological Parameters in Patients with Chronic Hepatitis B Infection in Zaria, Nigeria.
Hepatitis B virus (HBV) is one of the major causes of morbidity and mortality worldwide. The aim of this study was to determine the haematological and immunological parameters in patients with chronic HBV infection in Zaria, Nigeria. Twenty individuals with confirmed chronic HBV (CHB) infection constituted the subjects while 20 non-HBV-infected individuals were monitored as controls. The subjects were enrolled purposively from the Gastroenterology Clinic of the Ahmadu Bello University Teaching Hospital Shika, Zaria Nigeria. Four millilitres of blood samples were collected from each study participants. Full blood count was conducted using the Swelab Alfa Haematology Analyzer, while CD4+ T-Cell enumeration was performed using the Sysmex Partec CyFlow® Counter IVD flow cytometer according to the manufacturers' instruction. The mean (and standard deviation) age of the 20 participants with CHB was 32.7 (±10.1) years while that of the 20 HBV negative control participants was 30.0 (±7.8) years. Mann-Whitney test showed no significant difference between the two groups in their total WBC (p=0.6634) and granulocytes (p=0.2386). There was a significant increase in the monocytes count (p=0.0151) and a significant decrease in the lymphocytes count (p=0.0006) of patients with CHB compared to the healthy control. There was no significant difference in the mean CD4+ T-lymphocytes count between subjects and controls (p=0.0633). Unpaired Student t-test showed no significant difference between the two groups in the other haematological parameters. This study showed a significant increase in monocytes and decrease in lymphocytes, a phenomenon that characterize the sustenance of infection by immune evasion mechanism.


[Preparation and evaluation of clarithromycin emulsion for injection].
To prepare clarithromycin emulsion and investigate its pharmacokinetics in rats. And to do irritation test of the emulsion. High pressure homogenization method was used to prepare clarithromycin emulsion, and the Nicomp380 machine was used to test the mean particle size and zeta-potential of clarithromycin emulsion. Irritation of emulsion was also evaluated compared with the positive control of clarithromycin solution using rat paw lick test and rabbit ear vein irritation test. Microbiological assay method was used for determining the drug concentration in plasma. Pharmacokinetics of two dosage forms in rats was also studied. The mean particle size and zeta potential of clarithromycin emulsion were 156 nm and -31.8 mV, respectively. The emulsion was stable during the storage time at 4 degrees C for 6 month. The pain caused by emulsion reduced significantly compared with that of clarithromycin solution based on the results of rat paw lick test and rabbit ear vein test. The drug concentration-time curves of clarithromycin emulsion and clarithromycin solution were similar and could be described by two compartment model. AUC(0-1) of clarithromycin emulsion and clarithromycin solution were (66.76 +/- 16.34) and (59.00 +/- 11.20) microg x h x mL(-1), respectively. Stable emulsion could be prepared using high pressure homogenization method, and irritation caused by i.v. injection could be reduced significantly by using clarithromycin emulsion.


Structural Modulation of Nitrogen-Rich Covalent Organic Frameworks for Iodine Capture.
Developing efficient adsorbent materials for iodine scavenging is essential to mitigate the threat of radioactive iodine causing adverse effects on human health and the environment. In this context, we explored N-rich two-dimensional covalent organic frameworks (COFs) with diverse functionalities for iodine capture. The pyridyl-hydroxyl-functionalized triazine-based novel 5,5',5″-(1,3,5-triazine-2,4,6-triyl)tris(pyridine-2-amine) (TTPA)-COF possesses high crystallinity (crystalline domain size: 24.4 ± 0.6 nm) and high porosity (specific BET surface area: 1000 ± 90 m2 g-1). TTPA-COF exhibits superior vapor-phase iodine adsorption (4.43 ± 0.01 g g-1) compared to analogous COF devoid of pyridinic moieties, 2,4,6-tris(4-aminophenyl)-1,3,5-triazine (TAPT)-COF. The high iodine capture by TTPA-COF is due to the enhanced binding affinity conferred by the extra pyridinic active sites. Furthermore, the crucial role of long-range order in porous adsorbents has been experimentally evidenced by comparing the performance of iodine vapor capture of TTPA-COF with an amorphous network polymer having identical functionalities. We have also demonstrated the high iodine scavenging ability of TTPA-COF from the organic and aqueous phases. The mechanism of iodine adsorption by the heteroatom-rich framework is elucidated through FTIR, XPS, and Raman spectral analyses. The present study highlights the need for structural tweaking of the building blocks toward the rational construction of advanced functional porous materials for a task-specific application.


Disease progression in HIV-positive women with moderate to severe immunosuppression: the role of depression. Dana Consortium on Therapy for HIV Dementia and Related Cognitive Disorders.
Thirty-seven HIV-positive women were recruited in a 2-year prospective investigation into the role of depression in HIV disease progression. All participants had CD4+ cell counts of 200 or less at baseline and at least 3 CD4+ cell counts during follow-up. Participants were evaluated semiannually for CD4+ lymphocyte counts, B2Microglobulin (B2M), hemoglobin data, and new AIDS-defining illnesses. The Center for Epidemiologic Studies Depression Scale was used to assess for depressed mood. Over time, average rates of change in CD4+ counts did not differ significantly between depressed and nondepressed women, even after adjustment for age, antiretroviral use, and baseline CD4 count, and depressed women did not differ from nondepressed women in numbers of new AIDS-defining illnesses. The authors concluded that depression may not be a significant determinant of disease progression in women with advanced disease and called for further investigations with larger samples and women at earlier stages of the infection.


First Report of Dasheen Mosaic Virus Infecting Typhonium giganteum Engl. (Baifuzi) in Henan Province of China.
Typhonium giganteum Engl. (Baifuzi ) is a perennial plant of the family Araceae. In China, its root is commonly used as an antispasmodic for stroke and cancer treatment (Chi et al. 2010; Gao et al. 2014; Khalivulla et al. 2019). Yuzhou city in Henan Province is the main producing area of T. giganteum Engl., and in July 2020, a survey of viral disease infecting T. giganteum Engl. was conducted in the city. In the surveyed fields (n =5), over 60% of plants displayed varying levels of virus-like symptoms, including mosaic, chlorotic and leaf distortion (Supplementary Figure S1) . To identify possible viral pathogens associated with the disease symptoms afflicting T. giganteum Engl., one leaf each from 25 symptomatic plants was collected and analyzed by high-throughput sequencing (HTS) as well as PCR. For HTS analysis, total RNA was extracted from one pooled sample containing a portion of all abovementioned leaves using RNAprep Pure Plant Plus Kit (TIANGEN Biotech, Beijing, China). After removing ribosomal RNA with Ribo-off rRNA depletion kit (Vazyme Biotech, Nanjing, China), a sequencing library was generated using NEBNext Ultra RNA Library Prep Kit for Illumina (NEB, USA) and sequenced on an Illumina Novaseq6000 sequencing system at Berry Genomics Corporation (Beijing, China). A total of 6,899,143 high-quality clean reads were obtained after trimming and used for contig assembly. BLASTn and BLASTx analyses on the contigs (n = 128,400) showed that one contig (9,245 bp in length) exhibited a sequence identity of 84.0% with the reference sequence of dasheen mosaic virus (DsMV, NCBI reference seq. NC_003537, genus Potyvirus, family Potyviridae) , suggesting infection of the plants by DsMV. No other viral sequences were detected in the sample. To confirm these results, a near full-length genomic sequence of DsMV was obtained from one sample (sample no. 39) by reverse transcription polymerase chain reaction (RT-PCR) of three overlapping fragments with the following primer pairs: DsMV-1F (5'-AAATTAAAACATCTCAACAAAACCTACA-3') /DsMV-4130R (5'-TTCATGGTCCTCGTGGAGTATA-3'), DsMV-3870F (5'-GAGGACGTGAGAATTCAAAGTCT-3')/DsMV-8250R (5'-GTCCAACCTTGCTTGATGCATGC-3'), DsMV-7690F (5'-GGAGCGACTCCTCTTCCAAAGTTGTG-3')/DsMV-10100R (5'-TGAACACCGTGCACGAAGCATCTC-3'). The PCR products were cloned into pMD19-T vector (TAKARA Biotech, Dalian, China) and sequenced. The near full-length genomic sequence of the isolate (DsMV-BF39) was 9,737 nt in length and deposited into GenBank under the accession no. MZ043618. BLASTn analysis of this sequence demonstrated that it shared an identity ranging from 78.6% (MG602234) to 85.6% (MG602227) with various DsMV isolates. To determine whether DsMV was closely associated with the symptoms observed in T. giganteum Engl., leaf tissues from 30 symptomatic plants and 22 asymptomatic plants were analyzed by RT-PCR using primer pairs DsMV-CPF (5'-TGTTCTGTGAACATGATGAAGTTG-3', sense) and DsMV-CPR (5'-GTAACTGTGGCCTGTTTACCAG-3', antisense) targeting a 916 bp fragment of the CP gene of DsMV. Amplicons with the expected size were detected from the 30 symptomatic plants but not from the 22 asymptomatic plants, suggesting a close association between DsMV infection and the observed symptoms. To our knowledge, this is the first report of DsMV infecting T. giganteum Engl.. Further study is needed to identify the specific symptoms induced by this virus in T. giganteum Engl. and to understand the biological characteristics, epidemiology, prevalence of this virus in China.


Socio-cultural inhibitors to use of modern contraceptive techniques in rural Uganda: a qualitative study.
Family planning is one of the cost-effective strategies in reducing maternal and child morbidity and mortality rates. Yet in Uganda, the contraceptive prevalence rate is only 30% among married women in conjunction with a persistently high fertility rate of 6.2 children per woman. These demographic indicators have contributed to a high population growth rate of over 3.2% annually. This study examines the role of socio-cultural inhibitions in the use of modern contraceptives in rural Uganda. This was a qualitative study conducted in 2012 among men aged 15-64 and women aged 15-49 in the districts of Mpigi and Bugiri in rural Uganda. Eighteen selected focus group discussions (FGDs), each internally homogeneous, and eight in-depth interviews (IDIs) were conducted among men and women. Data were collected on sociocultural beliefs and practices, barriers to modern contraceptive use and perceptions of and attitudes to contraceptive use. All interviews were tape recoded, translated and transcribed verbatim. All the transcripts were coded, prearranged into categories and later analyzed using a latent content analysis approach, with support of ATLAS.ti qualitative software. Suitable quotations were used to provide in-depth explanations of the findings. Three themes central in hindering the uptake of modern contraceptives emerged: (i) persistence of socio-cultural beliefs and practices promoting births (such as polygamy, extending family lineage, replacement of the dead, gender-based violence, power relations and twin myths). (ii) Continued reliance on traditional family planning practices and (iii) misconceptions and fears about modern contraception. Sociocultural expectations and values attached to marriage, women and child bearing remain an impediment to using family planning methods. The study suggests a need to eradicate the cultural beliefs and practices that hinder people from using contraceptives, as well as a need to scale-up family planning services and sensitization at the grassroots.


[Clinical evaluation of isometric detrusor pressure in patients with benign prostatic hyperplasia].
The subjects chosen for this investigation were 88 patients with benign prostatic hyperplasia who proved not to have neurogenic bladder and 6 male volunteers without lower urinary tract disorders. In addition to the conventional preoperative urodynamic studies, isometric detrusor pressure was measured by the technique with balloon occlusion at the bladder neck. Although all 88 patients had undergone either transurethral resection of the prostate or subcapsular prostatectomy and routine postoperative examinations revealed sufficient canal formation in the prostatic urethra, in 23 patients (26.1%) a significant amount of residual urine was still observed and/or maximum urinary flow rate was considerably low. A retrospective analysis of the data from this study suggested that maximum isometric detrusor pressure is a useful parameter for the prediction whether or not micturition is improved after the removal of organic lower urinary tract obstruction, especially in cases with low detrusor pressure during urination. Furthermore, measurement of the maximum isometric detrusor pressure might be helpful in making the diagnosis of the clinical stage of benign prostatic hyperplasia, since several different stages could be defined by the value of maximum detrusor pressure during urination and maximum isometric detrusor pressure.


Continuum of care in maternal, newborn and child health in Pakistan: analysis of trends and determinants from 2006 to 2012.
Pakistan, being a developing country, presents the dismal picture of maternal and neonatal mortality and morbidity. The majority of maternal and neonatal deaths could be avoided if Continuum of Care (CoC) is provided in a structured pathway from pregnancy to birth and to the first week of life of the newborn child. This study aimed to analyse the trends of CoC at all three levels (antenatal care, skilled delivery and postpartum care) and to identify various factors affecting the continuation in receiving CoC in Pakistan during 2006 to 2012. Secondary data analysis was performed on nationally representative data from the last two iterations of Pakistan Demographic and Health Survey (PDHS), conducted during 2006/07 to 2012/13. The analysis is limited to women of the reproductive age group (15-49 years) who gave birth during the last five years preceding both surveys. This leads to a sample size of 5,724 and 7,461 respondents from PDHS 2006/07 and 2012/13 respectively. The association between CoC and several factors, including individual attributes (reproductive status), family influences, community context, as well as cultural and social values was assessed in bivariate analyses in a first step. Furthermore, odds ratios and adjusted odds ratios with 95% confidence intervals using a binary and multivariable logistic regression were calculated. Our research presents the trends of a composite measure of CoC including antenatal care, delivery assistance and postpartum care. The largest gap in CoC was observed at antenatal care followed by delivery and postnatal care within 48 h after delivery. Results show that CoC completion rate has increased from 15% to 27% amongst women in Pakistan over time from 2006 to 2012. Women with high age at first birth, having less number of children, with higher education, belonging to richest quintile, living in Sindh province and urban areas, having high autonomy and exposure to mass media were most likely to avail complete CoC. The findings show that women in Pakistan still lack the CoC. This calls for attention to develop and implement tailored interventions, focusing on the needs of women in Pakistan to provide CoC in an integrated manner, involving both public and private sectors by appropriately addressing the factors hindering CoC completion rates.


Diagnosis and management of spinal tuberculosis combined with brucellosis: A case report and literature review.
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression. Tuberculosis was suspected, but subsequent culture of blood and pus revealed the co-infection of Mycobacterium tuberculosis and Brucella melitensis. The patient was treated with antibiotics, CT-guided percutaneous drainage of the abscess and posterior approach decompression, debridement, instrumentation and fusion. Co-existence of spinal tuberculosis and brucellosis is rare and clinicians should strengthen the awareness of such conditions in similar patients. CT-guided percutaneous drainage is effective in the diagnosis and management of spinal tuberculosis with abscess.


Malignant rhabdoid tumor of the omentum in an adult male: a case report and literature review.
Malignant rhabdoid tumors (MRTs) are rare tumors with high mortality rates and poor prognoses. MRTs occur mainly in the central nervous system, kidneys, and soft tissues, but rarely in the omentum. MRTs occur more commonly in infants and children and less frequently in adults. Here, we report the first observed case of MRT in an adult omentum. A 35-year-old man with abdominal distension and pain was admitted to the emergency department. Previously, several hospitals considered patients with cirrhosis who had not received active treatment. Computed tomography and magnetic resonance imaging revealed diffuse omental thickening and massive ascites. The surgery was performed at our hospital, and the pathological diagnosis was MRT with a SMARCB1(INI-1) deletion. Postoperatively, his symptoms improved, and he underwent five cycles of chemotherapy. However, 6 months after surgery, the tumor developed liver metastases, and the patient subsequently died. Primary MRT of the greater omentum is rare, and its pathological diagnosis usually requires extensive clinicopathological evaluation of various differential diagnoses and an appropriate work-up to exclude other malignancies associated with SMARCB1 deletion. At the same time, the lack of specific signs of omental MRT and its rapid progression should alert clinicians.


Repair and follow-up of Tetralogy of Fallot with pulmonary stenosis.
Tetralogy of Fallot is the most common cyanotic congenital heart defect. Advances in surgical technique and postoperative care have improved survival which is now very good. Patients now face long-term morbidities such as reduced exercise tolerance and arrthymias. Cardiologists caring for these patients are confronted with decisions regarding best care practices. This article will review the evidence available on repair and postoperative follow-up for patients with Tetralogy of Fallot with pulmonary stenosis.


Occult injuries of the talus diagnosed by bone scan and tomography.
Five patients, four women and one man, were found to have an osteochondral lesion of one of the talar joints. All patients had normal plain radiographs of the ankle and foot and were referred to us as a second or third consultation for undiagnosed ankle and hindfoot pain. Bone scans of the tali demonstrated the specific talar joint that was injured, and tomography confirmed the presence of an osteochondral lesion. The average delay in the diagnosis between the onset of symptoms and the initiation of treatment was over 10 months. Bone scanning is an effective diagnostic tool in locating injuries of the talus not appreciated on routine x-ray.


Byssinosis and tuberculosis among textile mill workers in Bahar Dar, Ethiopia.
A cross-sectional study was conducted in 1991 on 433 workers of a cotton mill in Bahar Dar, northern Ethiopia. The study consisted of symptom evaluation using a standardized questionnaire, lung function tests, chest x-ray, and measurement of dust concentration in the various work areas. A hundred non-exposed hospital workers were included as control group. The overall prevalence of byssinosis among the exposed subjects was 45.5%, being highest among carding (57.9%) and ring frame workers (57.1%). Lower prevalences were found in weavers (36.7%) and those working in the preparatory unit (32.1%). Chronic bronchitis occurred in 48.8% of workers in the carding section, and in none of the control group. Bronchial asthma occurred in 11.5% of workers in the carding and ring frame sections, and in 28.6% of the workers in the waste section. Twelve per cent of the control group had bronchial asthma. Tuberculosis was prevalent in 5.3% of the mill workers and in 2.1% of the control group. Ventilatory capacity (FEV1 and FVC) was significantly reduced in the exposed workers (p < 0.05). The study revealed that the prevalence of byssinosis and other respiratory disorders was extremely high among the cotton mill workers. In view of the above findings preventive measures deserve a high priority.


Late Recurrence of Renal Cell Carcinoma in Unusual Sites 23 Years After Nephrectomy.
Renal cell carcinoma (RCC) is a common malignancy in the elderly population and it is notorious for its mechanism of late metastasis to unusual anatomical sites. Late recurrences are common following curative treatment, such as radical nephrectomy. Pancreatic metastases and hepatic metastatic lesions make the diagnosis and classification of a primary tumor challenging. This necessitates a high index of suspicion and an extensive interrogation. We present the case of a 68-year-old Hispanic female with progressive pain in the right upper quadrant, weight loss, and decreased appetite. She has a history of renal cell carcinoma treated with radical nephrectomy and radiotherapy. A pancreatic biopsy was performed based on the ultrasound and computed tomography findings at a private clinic. Subsequently, the patient was referred to the Instituto Oncologico Nacional (ION) due to immunohistochemical features suggestive of a well-differentiated neuroendocrine tumor. At ION, a more comprehensive medical history was obtained, and the immunohistochemistry panel was extended, confirming the diagnosis of late recurrence of RCC. One possible explanation for the very late relapse of our patient is the presence of malignant cells that were spared or seeded during the surgical intervention and remained dormant or latent, subsequently spreading via hematogenous dissemination or via the lymphatic system. We highlight the importance of medical history, pathological examination, and immunohistochemical analysis in establishing a differential diagnosis, given the nature of RCC, which can often present asymptomatically and has a propensity for late recurrence. Further research should focus on developing standardized surveillance protocols for such cases.


High-speed chaos-based secure optical communications over 130-km multi-core fiber.
Chaotic optical communication is of great significance for secure data transmission. Despite rapid development over the decades, high-speed (>100 Gbps) and long-distance (>100 km) chaotic optical communication in a single fiber is still full of challenges. Here, we propose and experimentally demonstrate high-speed and long-distance chaos-based secure optical communications using mutual injection of semiconductor lasers and space-division multiplexing (SDM) techniques. The encrypted signals are transmitted through all seven core channels of the multi-core fiber (MCF), which effectively expands the aggregate transmission capacity of a single fiber. A pair of source and synchronization devices based on mutual injection of semiconductor lasers are employed to effectively encrypt and decrypt signals. Chaos-based secure optical communications with 70-Gbps on-off keying (OOK) and 140-Gbps quadrature phase-shift keying (QPSK) signals over a 130-km MCF are successfully demonstrated in the experiment with favorable performance. The demonstration may pave the way for future ultrahigh capacity and ultra-long distance chaotic optical communications by fully exploiting multi-dimensional resources of light waves, including the spatial dimension.


Protective effect of resveratrol against neuronal damage following transient global cerebral ischemia in mice.
Resveratrol (3,5,4'-trihydroxystilbene) is a natural polyphenol which is rich in grape seeds and skin. Several studies have revealed that resveratrol possesses neuroprotective effects. In the case of global brain ischemia, there are few reports regarding the protective effect of resveratrol. Therefore, the influence of resveratrol on neuronal damage after transient global brain ischemia remains to be clarified. In the current study, C57BL/6 black mice were subjected to 20 min of transient global brain ischemia and followed by 72 h of reperfusion. Resveratrol (20 or 40 mg/kg, once daily, dissolved in 0.5% carboxymethylcellulose) was administered orally for 7 days before ischemia and daily until the mice were euthanized. The effect of lower or higher dose of resveratrol on neuronal damage, matrix metalloproteinase (MMP) activity and in situ DNA fragmentation (TUNEL) assay in the hippocampus after global ischemia was examined. Neuronal damages were remarkable in CA1 and CA2 pyramidal cell layers after global ischemia. In resveratrol-treated mice (40 mg/kg), neuronal damage was significantly reduced compared with vehicle-treated mice. Mice treated with resveratrol showed reduced MMP-9 activity. Resveratrol also inhibited TUNEL staining. These data suggest that resveratrol, a natural polyphenol, reduces hippocampal neuronal cell damage following transient global ischemia by reducing MMP-9 activity.


The UK NEQAS for Molecular Genetics scheme for gastrointestinal stromal tumour: findings and recommendations following four rounds of circulation.
To describe the UK NEQAS for Molecular Genetics scheme for gastrointestinal stromal tumour (GIST) and to report and interpret the findings of four rounds of circulation of this quality assurance programme for KIT/PDGFRA mutation analyses. Samples of GISTs from formalin-fixed paraffin-embedded tissue blocks were circulated to registered participants of the UK NEQAS for Molecular Genetics scheme for GIST. Three samples were provided per annual circulation from 2008 to 2011 inclusive. The participants were required to analyse the samples for KIT and/or PDGFRA mutations using their routine protocols, and the anonymised participants' reports were assessed and an annual scheme report issued. The genotyping error rates for the 2008, 2009, 2010 and 2011 circulations were 13%, 33%, 19% and 4%, respectively. These errors were either missed or incorrectly described mutations. There was an overall false negative rate of 2% and false positive rate of 0%. The main recommendations that arose from these circulations were: (1) inclusion of reference accession numbers in reports; (2) avoidance of the term 'heterozygous' when analysing DNA from tumour tissue unless there was certainty that only neoplastic DNA was studied; and (3) the need to screen KIT exons 9, 11, 13 and 17 and PDGFRA exons 12, 14 and 18 before classifying a GIST as 'wild type'. The UK NEQAS for Molecular Genetics scheme emphasises the potential complexities of KIT/PDGFRA mutation analyses for GISTs and provides recommendations to help optimise such genotyping and reporting. The scheme has also demonstrated its educational value among participating laboratories.


A Learner-led, Discussion-based Elective on Emerging Infectious Disease.
Objective. To implement a learner-led, discussion-based course aimed at exposing second-year pharmacy learners to the study of emerging infectious diseases from a global health perspective and to assess the role and importance of pharmacists in the management of disease outbreaks. Design. Learners examined literature pertinent to an emerging infectious disease in a 3-credit, discussion-based course and participated in peer discussion led by a designated learner. Instructional materials included journal articles, audio-visual presentations, documentaries, book chapters, movies, newspaper/magazine articles, and other materials. Learning outcomes were measured based on the ability of learners to perform critical thinking and analysis, communicate with their peers, and participate in class discussions. Assessment. The course was offered to 2 consecutive cohorts consisting of 14 and 16 learners, respectively. Overall, every learner in the first cohort achieved a final grade of A for the course. In the second cohort, the overall grade distribution consisted of grades of A, B, and C for the course. Learner evaluations indicated that the active-learning, discussion-based environment significantly enhanced interest in the topic and overall performance in the course. Conclusion. The elective course on emerging infectious diseases provided in-depth exposure to disease topics normally not encountered in the pharmacy curriculum. Learners found the material and format valuable, and the course enhanced their appreciation of infectious diseases, research methodology, critical thinking and analysis, and their roles as pharmacists.


Evolutionary morphology in Belgium: the fortunes of the "van Beneden School," 1870-1900.
In historical literature, Edouard van Beneden (1846-1910) is mostly remembered for his cytological discoveries. Less well known, however, is that he also introduced evolutionary morphology--and indeed evolutionary theory as such--in the Belgian academic world. The introduction of this research programme cannot be understood without taking both the international and the national context into account. It was clearly the German example of the Jena University that inspired van Beneden in his research interests. The actual launch of evolutionary morphology at his University of Liège was, however, also connected with the dynamic of Belgian university reforms and the local rationale of creating a research "school." Thanks to his networks, his mastering of the rhetoric of the "new" biology, his low ideological profile and his capitalising on the new academic élan in late-19th century Belgium, van Beneden managed to turn his programme into a local success from the 1870s onwards. Two decades later, however, the conceptual underpinnings of evolutionary morphology came under attack and the "Van Beneden School" lost much of its vitality. Despite this, van Beneden's evolutionary morphology was prototypical for the research that was to come. He was one of the first scientific heavyweights in Belgium to turn the university laboratory into a centre of scientific practice and the hub of a research school.


Biosynthesis and glycosylation of the carcinoma-associated antigen recognized by monoclonal antibody KS1/4.
Monoclonal antibody KS1/4 recognizes an epitope expressed on the cell surface of human adenocarcinoma cells and certain epithelia. Western blotting analyses of tumor cell extracts utilizing KS1/4 reveal staining of a major Mr 40,000 band and a minor Mr 42,000 band. Both components are also detectable in KS1/4 immunoprecipitates of L-[35S]methionine- and D-[3H]glucosamine-labeled human lung tumor cell extracts. When synthesis occurs in the presence of tunicamycin or when the immunoprecipitates are treated with peptide:N-glycosidase F, a single polypeptide component (Mr 37,000) is precipitated. Immediately following translation, digestion of Mr 40,000 and Mr 42,000 glycoproteins with endo-beta-N- acetylglucosaminidase H also yields a single polypeptide component at Mr 37,000. However, over a 3-h period beginning at 10 min posttranslation, a Mr 39,000 major component and a Mr 41,000 minor component gradually appear in the endo-beta-N-acetylglucosaminidase H digests as the Mr 37,000 component gradually disappears. Analysis of tryptic glycopeptides derived from the Mr 40,000 and 42,000 components suggests that the two components differ by the addition of one extra oligosaccharide to the Mr 42,000 component. Nonequilibrium pH gradient electrophoresis/sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of KS1/4 immunoprecipitates resolves each of the two components into multiple spots. Digestion of the KS1/4 immunoprecipitates with neuraminidase prior to two-dimensional analysis or immunoprecipitation of short pulse-labeled extracts reduces the number of spots to three each at the Mr 40,000 and Mr 42,000 positions. Digestion of the KS1/4 immunoprecipitates with peptide:N-glycosidase F, immunoprecipitation of extracts labeled in the presence of tunicamycin, or endo-beta-N-acetylglucosaminidase H digestion of immunoprecipitates of short pulse-labeled extracts prior to two-dimensional analysis results in a single series of Mr 37,000 spots, suggesting that the polypeptide portions of the Mr 40,000 and Mr 42,000 components may be identical. Endo-beta-N-acetylglucosaminidase H digestion of KS1/4 immunoprecipitates of short pulse-labeled extracts, followed by nonequilibrium pH gradient electrophoresis, V8 protease digestion, and polyacrylamide gel electrophoresis revealed an apparently identical set of polypeptides derived from each of the three Mr 37,000 spots, suggesting that the three spots derive from highly similar polypeptides.


Gastric electrical activity in normal neonates during the first year of life: effect of feeding with breast milk and formula.
To evaluate the effect of feeding with milk on the gastrointestinal tract, we studied gastric electrical activity in 27 healthy fullterm newborns (15 formula-fed newborns and 12 breast-fed newborns) during the first 6 months of life. Three-hour electrogastrography (EGG) recordings were performed, using portable equipment, from the third to fifth day after birth until 6 months, at 3-month intervals. The EGG parameters were calculated as raw and integrated data, the latter as AUC of the whole postprandial period. There was a significant difference in the fasting 3-cpm activity between the two groups (repeated measures analysis of variance [ANOVA] P=0.02; multiple comparisons: formula milk at birth vs breast milk at birth P<0.001). In addition, a significant change in the percentage of postprandial bradygastria was found at 6 months, 1 month after weaning (repeated measures ANOVA, P=0.01; multiple comparisons: formula milk at 6 months vs formula milk at 3 months, P=0.03, formula milk at 6 months vs formula milk at birth, P=0.02; breast milk at 6 months vs breast milk at 3 months, P=0.03, breast milk at 6 months vs breast milk at birth P=0.02). An adult-like gastric 3-cpm activity can be observed in breast-fed newborns in contrast to formula-fed ones, probably as an effect of colostrum. The high bradygastria percentage recorded at 6 months of life might be the result of an increased low-frequency component of the EGG signal because of the transition to a mixed diet.


Effect of vitamin E on IgE antibody formation in mice.
Effect of vitamin E (alpha-tocopheryl acetate and alpha-tocopheryl nicotinate) on IgE antibody formation in mice was investgiated . Female BALB/c mice were immunized with dinitrophenylated ascaris protein (DNP-As) and aluminium hydroxide gel (alum). Supplementation of vitamin E in diets or oral administration of vitamin E mixed with sesame oil resulted in a suppression of IgE antibody formation. On the contrary to IgE antibody formation, IgM or IgG (hemagglutinin; HA) formation was significantly enhanced. These results indicate that vitamin E is capable of suppressing IgE antibody formation and enhancing non-IgE antibody formation.


Activatable Near-Infrared Versatile Fluorescent and Chemiluminescent Dyes Based on the Dicyanomethylene-4H-pyran Scaffold: From Design to Imaging and Theranostics.
Activatable fluorescent and chemiluminescent dyes with near-infrared emission have indispensable roles in the fields of bioimaging, molecular prodrugs, and phototheranostic agents. As one of the most popular fluorophore scaffolds, the dicyanomethylene-4H-pyran scaffold has been applied to fabricate a large number of versatile activatable optical dyes for analytes detection and diseases diagnosis and treatment by virtue of its high photostability, large Stokes shift, considerable two-photon absorption cross-section, and structural modifiability. This review discusses the molecular design strategies, recognition mechanisms, and both in vitro and in vivo bio-applications (especially for diagnosis and therapy of tumors) of activatable dicyanomethylene-4H-pyran dyes. The final section describes the current shortcomings and future development prospects of this topic.


Pregnancy outcomes in Southeast Asian migrant workers at Southern Thailand.
This retrospective study was conducted to determine the pregnancy outcomes and identify predictive factors of adverse outcomes in pregnant migrant workers who delivered at Songklanagarind Hospital from January 2002 to December 2012. Two hundred and forty migrant worker pregnancies were enrolled. Pre-eclampsia, gestational diabetes mellitus, pre-term birth and foetal intrauterine growth restriction found were 15, 7.9, 13.7 and 3.7%, respectively. No stillbirth was found. Apgar score was </ = 7 at 1 and 5 min and neonatal intensive care unit admission was found to be 12.1, 4.2 and 11.3%, respectively. Antenatal care place, low haemoglobin level and the presence of maternal underlying disease were significantly related to increased risk of overall adverse maternal outcomes. Only pre-term birth was significantly related to overall adverse neonatal outcomes.


The expanding role of antiplatelet agents in coronary artery disease. A current review of aspirin, glycoprotein IIb/IIIa inhibitors, and the thienopyridines.
The platelet has assumed an increasingly important role in cardiovascular medicine as our understanding of the pathophysiology of acute coronary syndromes (ACS) has evolved. Plaque rupture, platelet aggregation, and thrombus formation occur as a result of complex interaction between the platelet, the endothelium, and various inflammatory cells and circulating proteins. Aspirin continues to form the foundation of any anti-ischemic regimen, but cardiologists have long recognized the need for newer, more potent antiplatelet agents. Glycoprotein IIb/IIIa receptor antagonists and thienopryidines have been developed over the past decade and now serve as powerful complements to aspirin in the prevention and treatment of coronary events. The paper will begin with a review of aspirin as well as a discussion of the concept of aspirin resistance. The rapidly expanding body of knowledge supporting the use of glycoprotein IIb/IIIa receptor blockers and thienopyridines will then be addressed, with an emphasis on reconciling recent controversies in the literature. Future advances in the treatment of coronary artery disease will likely occur as we further refine the role of these established antiplatelet drugs and develop agents that bind to novel targets in the thrombotic cascade.


Investigating prophylactic botulinum toxin type A for chronic headache disorders.
There is an increasing number of studies on botulinum toxin A in the treatment of idiopathic and symptomatic headache; however, many studies can hardly be compared with each other because of different end points and different trial designs. For the prophylactic treatment of tension-type headache, migraine and cervicogenic headache, no sufficient positive evidence for a successful treatment can be obtained from the randomised, double-blind and placebo-controlled trials performed so far. For the treatment of chronic daily headache (including medication-overuse headache), there is inconsistent positive evidence for subgroups (e.g., patients without other prophylactic treatment). This means that most of the double-blind and placebo-controlled studies do not confirm the assumption that botulinum toxin A is efficacious in the treatment of idiopathic headache disorders; however, it is possible that some subgroups of patients with chronic migraine benefit from a long-term treatment for > or = 6 months.


Thyrotropin dependent and independent thyroid cell lines selected from FRTL-5 derived tumors grown in nude mice.
FRTL-5 cells were used to set up a thyroid tumor model system in C3H nu/nu mice. FRTL-5 tumors could be grown in nude mice provided serum TSH levels were elevated. Persistent TSH elevation was obtained by administration of Na131I, rendering the mice hypothyroid. After 4 weeks FRTL-5 cells were injected sc resulting in tumor growth within 2 weeks in eight out of eight mice. Although the tumors showed an apparently undifferentiated histology, lacking normal follicular structures, they were functional since the tumors were capable of concentrating [131]iodine, as demonstrated by nuclear imaging. From one of the tumors a new cell line was isolated (FRTL-5/T) that, like the parental FRTL-5 cell line, was TSH dependent for growth. In a control group of six euthyroid nude mice FRTL-5 tumor growth could not be obtained with one exception. After 3 months one animal developed a small tumor that grew rapidly thereafter. This tumor was easily transplantable in other euthyroid nude mice, showed an undifferentiated histology, and was nonfunctional, as it could not concentrate [131]iodine. From this tumor two cell lines were derived: one cultured in the presence of TSH (FRTL-5/TP) and one in the absence of TSH (FRTL-5/TA). Both cell lines were found to be TSH independent for growth. The cell lines were analyzed for TSH responsive functions and TSH receptor expression. Responsiveness to TSH in FRTL-5/T and the parental FRTL-5 cell line were similar for most thyroid specific functions tested. However, FRTL-5/T was less sensitive than FRTL-5 for TSH induced [3H]thymidine incorporation. Both cell lines had two classes of TSH binding sites with high and low affinity respectively, as determined by Scatchard analysis. FRTL-5/TP and FRTL-5/TA were both able to grow in TSH free medium and were nonresponsive to TSH in vitro, as tested for [3H]thymidine and [3H]uridine incorporation, iodine uptake, thyroglobulin iodination, and thyroglobulin secretion. This correlated with an approximately 100-fold decreased number of TSH binding sites compared to FRTL-5. The latter was caused by a complete absence of low affinity binding sites, whereas high affinity receptors were still detectable. The FRTL-5/TA cell line was the least differentiated one as thyroglobulin mRNA was detectable in only minute amounts and thyroid peroxidase expression could not be measured. These in vivo selected FRTL-5 cell lines offer a suitable model to investigate several aspects of TSH responsiveness, including signal transduction and postreceptor events, thyroid differentiation, and thyroid tumorigenesis.


Influence of the a-ring on the proton affinity and anticancer properties of the prodigiosins.
Prodigiosin (Prod, 1) is the parent member of a class of polypyrrole natural products that exhibit promising immunosuppressive and anticancer activities. They are known to act as H+/Cl- symporters possibly through electrostatic binding to Cl- that facilitates proton-coupled transmembrane transport of halides. This activity has been ascribed to their promotion of apoptosis by acidification of the intracellular pH (pHi). Since the protonated pyrromethene chromophore of Prod (1) is expected to play a critical role in pHi regulation, and the A-pyrrole ring is known to be important for anticancer activity, we prepared several Prod analogues with various A-ring systems to determine their proton affinity in 1:1 (v/v) acetonitrile (MeCN)/H(2)O and anticancer properties against HL-60 cancer cells. Our studies show that the A-ring strongly influences the proton affinity of the pyrromethene entity. Replacement of the C-2 methoxy group in 2,4-dimethoxy-pyrromethene 3 (apparent pK(a) = 4.95) with the A-pyrrole ring to generate the Prod analogue 5 raised the apparent pK(a) to 7.54 (increase by 2.59 pK units) and caused a 76 nm red shift in the UV-vis absorbance of the protonated species (AH+). The A-pyrrole NH atom plays an important role in stabilization of AH+, as its replacement with O or S atoms decreases the apparent pK(a) by 0.79 and 1.07 pK units, respectively. A 4-substituted phenyl series of Prod analogues 8-14 exhibited a linear correlation with the Hammett sigma(p) values. Within the phenyl series, two Prod analogues were found to inhibit colony formation of HL-60 cancer cells, although the inhibition did not correlate with the proton affinity of the pyrromethene entity. The implications of these findings with regard to the anticancer activities of the prodigiosins are discussed.


Serological activity of lipids of a T strain of Mycoplasma.
Complement-fixing activity of a T strain of Mycoplasma was found to be associated with its lipid components. Heat stability and lability of periodate and beta-glucosidase treatments led to the conclusion that complement-fixing, active lipids had carboydrate determinants. Periodate treatment of chromatographic fractions of a chloroform-methanol extract showed that only antigens contained in the acetone fraction were periodate labile. Lipids also appeared to be involved in the passive hemagglutination, since the lipid fraction active in complement fixation also combined and blocked the action of antibodies which agglutinated sensitized erythrocytes with strain P108.


Release of uremic retention solutes from protein binding by hypertonic predilution hemodiafiltration.
Protein-bound uremic retention solutes accumulate in patients suffering from chronic kidney disease, and the removal of these solutes by hemodialysis is hampered. Therefore, we developed a dialysis technique where the protein-bound uremic retention solutes are removed more efficiently under high ionic strength. Protein-bound uremic solutes such as phenylacetic acid, indoxyl sulfate, and p-cresyl sulfate were combined with plasma in the presence of increased ionic strength. The protein integrity of proteins and enzymatic activities were analyzed. In vitro dialysis of albumin solution was performed to investigate the clearance of the bound uremic retention solutes. In vitro hemodiafiltrations of human blood were performed to investigate the influence of increased ionic strength on blood cell survival. The protein-bound fraction of phenylacetic acid, indoxyl sulfate, and p-cresyl sulfate was significantly decreased from 59.4% ± 3.4%, 95.7% ± 0.6%, 96.9% ± 1.5% to 36.4% ± 3.7%, 87.8% ± 0.6%, and 90.8% ± 1.3%, respectively. The percentage of phenylacetic acid, indoxyl sulfate, and p-cresyl sulfate released from protein was 23.0% ± 5.7%, 7.9% ± 1.1%, and 6.1% ± 0.2%, respectively. The clearance during in vitro dialysis was increased by 13.1% ± 3.6%, 68.8% ± 15.1%, and 53.6% ± 10.2%, respectively. There was no difference in NaCl concentrations at the outlet of the dialyzer using isotonic and hypertonic solutions. In conclusion, this study forms the basis for establishing a novel therapeutic approach to remove protein-bound retention solutes.


Possible induction of graft-versus-leukemia effect against a leukemia refractory to antileukemia response in ordinary MHC-compatible, allogeneic bone marrow transplantation.
We previously indicated that intensity of the graft-versus-leukemia (GVL) effect varied among different leukemias in MHC-compatible, allogeneic bone marrow transplantation (BMT). Cellular factors responsible for differences in intensity of the GVL effect were examined by using two types of leukemias, i.e., a resistant leukemia (LE750) and a sensitive leukemia (8313) to induction of the GVL effect in MHC-compatible, allogeneic BMT of leukemia-bearing host. Resistance of LE750 leukemic cells to induction of the GVL effect could not be attributed to either less sensitivity to lysis by minor H antigen-specific, cytotoxic T cells or to an immunosuppressive activity of LE750 leukemic cells in leukemia-bearing host, when compared with the case of the sensitive leukemia (8313). To investigate the significance of the dose effect of effector cells for induction of the GVL effect, we used CD8+ T cells of AKR donor mice, which were shown to preferentially induce the GVL effect with hardly any lethal graft-versus host disease against C3H recipient mice, enabling us to increase the number of CD8+ T cells used in the allogeneic donor inoculum. The results suggested that the outcome of the antileukemic response in allogeneic BMT of leukemic recipients may be determined, at least in part, by the balance between the size of leukemic cells surviving and repopulating in the recipients after BMT and the number of antileukemic effector cells. The results furthermore indicated that when donors with T-cell subsets that preferentially induce an antileukemic response with reduced graft-versus-host disease are available, a more effective antileukemic response is inducible even against advanced leukemias.


Structure, Biology, and Applications of Filamentous Bacteriophages.
The closely related Escherichia coli Ff filamentous phages (f1, fd, and M13) have taken a fantastic journey over the past 60 years, from the urban sewerage from which they were first isolated, to their use in high-end technologies in multiple fields. Their relatively small genome size, high titers, and the virions that tolerate fusion proteins make the Ffs an ideal system for phage display. Folding of the fusions in the oxidizing environment of the E. coli periplasm makes the Ff phages a platform that allows display of eukaryotic surface and secreted proteins, including antibodies. Resistance of the Ffs to a broad range of pH and detergents facilitates affinity screening in phage display, whereas the stability of the virions at ambient temperature makes them suitable for applications in material science and nanotechnology. Among filamentous phages, only the Ffs have been used in phage display technology, because of the most advanced state of knowledge about their biology and the various tools developed for E. coli as a cloning host for them. Filamentous phages have been thought to be a rather small group, infecting mostly Gram-negative bacteria. A recent discovery of more than 10 thousand diverse filamentous phages in bacteria and archaea, however, opens a fascinating prospect for novel applications. The main aim of this review is to give detailed biological and structural information to researchers embarking on phage display projects. The secondary aim is to discuss the yet-unresolved puzzles, as well as recent developments in filamentous phage biology, from a viewpoint of their impact on current and future applications.


Five-year survival after second-line cisplatin-based intraperitoneal chemotherapy for advanced ovarian cancer.
To evaluate the 5-year survival rates of second-line intraperitoneal chemotherapy in advanced-staged ovarian cancer. Between August 1985 and September 1991, 63 patients with advanced epithelial ovarian cancer received intraperitoneal cisplatin and cytarabine chemotherapy as second-line treatment. The median survival from the time of initiation of intraperitoneal chemotherapy (IPC) was 29.1 months. A significant advantage in 5-year survival (40%) and 5-year progression-free survival (37%) was observed among 21 patients who demonstrated a response to first-line and second-line treatment compared to those who demonstrated a response to first-line treatment only (6 and 0%, respectively) (P < 0.0001). No patient (n = 13) who failed to respond to either first-line or second-line treatment survived for 5 years. Among 42 patients with < or = 5 mm residual disease at the time of initiation of IPC, 5-year survival was 36% and 5-year progression-free survival was 31%, while no patient (n = 21) with residual disease measuring > 5 mm at the initiation of IPC survived 5 years (P < 0.0001). Given the limitation that this is not a randomized trial, the data appear to indicate that salvage platinum-based intraperitoneal chemotherapy results in significant 5-year survival and progression-free survival in selected patients who initiated therapy with small (< or = 5 mm) tumor burden. These survival rates as second-line therapy approach those achieved by first-line platinum-based intravenous chemotherapy in patients with advanced-stage ovarian cancer with similar small residual disease at the initiation of therapy.


[Functional saving in the treatment of cervical cancer].
The radicality of Okabayashi's radical hysterectomy for treatment of cervical cancer has been well-known. However, its radicality also brought up the disturbance of fertility, endocrine and sexual function as well as the dysfunction of micturition and defecation. As early cervical cancer cases have increased yearly, and social rehabilitation became more necessary nowadays, functional saving is important and must be considered as the responsibility of the oncologists. This report denotes the preservation of ovarian function, sexual rehabilitation as well as the fertility in the treatment of cervical cancer.


Exploring Knowledge, Attitudes, and Practices Related to Breast and Cervical Cancers in Mongolia: A National Population-Based Survey.
Mongolia bears the second-highest cancer burden in the world (5,214 disability-adjusted life years per 100,000 people, age standardized). To determine drivers of the growing burden of noncommunicable diseases, including breast and cervical cancers, a national knowledge, attitudes, and practices (KAP) survey was implemented in 2010. This paper analyzed the results of the 2010 KAP survey, which sampled 3,450 households nationally. Reflecting Mongolian screening policies, women aged 30 and older were included in analyses of questions regarding breast and cervical cancer (n = 1,193). Univariate and multivariate odds ratios (MORs) were derived through logistic regression to determine associations between demographic covariables (residence, age, education, employment) and survey responses. This study found that 25.7% (95% confidence interval [CI]: 23.3-28.3) and 22.1% (95% CI: 19.8-24.5) of female participants aged 30 years or older self-rated their knowledge of breast and cervical cancers, respectively, as "none." Employment and education were associated with greater awareness of both cancers and participation in screening examinations (p < .05). Clinical breast examinations were more common among rural than urban participants (MOR: 1.492; 95% CI: 1.125-1.979). Of all female participants, 17% (95% CI: 15.3-18.5) knew that cervical cancer is vaccine preventable. Our results suggest that cancer control in Mongolia should emphasize health education, particularly among lower-educated, rural, and unemployed women. The health infrastructure should be strengthened to reflect rural to urban migration. Finally, although there is awareness that early detection improves outcomes, a significant proportion of women do not engage in screening. These trends warrant further research on barriers and solutions. The rising burden of breast and cervical cancers, particularly in low- and middle-income countries, necessitates the development of effective strategies for cancer control. This paper examines barriers to health service use in Mongolia, a country with a high cancer burden. The 2010 national knowledge, attitude and practices survey data indicate that cancer control efforts should focus on improving health education among lower-educated, rural, and unemployed populations, who display the least knowledge of breast and cervical cancers. Moreover, the findings support the need to emphasize individual risk for disease in cancer education and ensure that the health-care infrastructure reflects Mongolia's urbanization.


Amelioration of human osteoarthritis symptoms with topical 'biotherapeutics': a phase I human trial.
Osteoarthritis (OA) treatments presently rely on analgesics, which manage pain but fail to restore imbalances between catabolic and anabolic processes that underlie OA pathogenesis. Recently, biologic (biotherapeutic) drugs, which alter the activity of catabolic agents such as nitric oxide and inflammatory cytokines in ways, allowing tissue regeneration, were evaluated for efficacy in OA treatment. These studies failed to demonstrate dramatic abatement of OA symptoms by these drugs, but suggested strategies by which biologic agents might be used to treat OA. The present review summarizes current understanding of OA pathogenesis and evolving treatments. Preliminary evaluations of a novel biotherapeutic strategy are presented here. Twenty OA patients receiving sour topical cherry seed extract (SCE), an inducer of heme oxygenase-1 (HO-1), a major physiological protectant against oxidative stress exhibited significantly decreased joint pain and activation of CD4+ T cells expressing inflammatory cytokines (p < 0.05), significantly decreased peripheral blood C-reactive protein (CRP), and increased leukocyte HO-1 (p < 0.05) in comparison with ten placebo-treated patients. SCE inhibits joint-damaging inflammatory mediator production. This agent therefore meets the main criterion for classification as a "biotherapeutic," or "biologic" agent. The negligible toxicity and low cost of such materials make them promising contributors to OA treatment, sustainable within resource limitations of a wide range of patients.


Trade-Offs between Speed, Accuracy, and Dissipation in tRNAIle Aminoacylation.
Living systems maintain a high fidelity in information processing through kinetic proofreading, a mechanism for preferentially removing incorrect substrates at the cost of energy dissipation and slower speed. Proofreading mechanisms must balance their demand for higher speed, fewer errors, and lower dissipation, but it is unclear how rates of individual reaction steps are evolutionarily tuned to balance these needs, especially when multiple proofreading mechanisms are present. Here, using a discrete-state stochastic model, we analyze the optimization strategies in Escherichia coli isoleucyl-tRNA synthetase. Surprisingly, this enzyme adopts an economic proofreading strategy and improves speed and dissipation as long as the error is tolerable. Through global parameter sampling, we reveal a fundamental dissipation-error relation that bounds the enzyme's optimal performance and explains the importance of the post-transfer editing mechanism. The proximity of native system parameters to this bound demonstrates the importance of energy dissipation as an evolutionary force affecting fitness.


Acquired hemophilia as a cause of primary postpartum hemorrhage.
A 32-year-old primigravid woman developed acquired factor VIII inhibitor after delivery. She presented with postpartum hemorrhage and large hematoma in episiotomy site. Laboratory examinations showed markedly prolonged activated partial thromboplastin time, low levels of factor VIII (8%), and factor VIII inhibitor (2 Bethesda units). The bleeding was controlled successfully using combined treatment with factor VIII, intravenous immunoglobulin, steroids, and recombinant factor VIIa. Six months after delivery, factor VIII inhibitor was not present and factor VIII concentration increased to normal range. Acquired hemophilia is a life-threatening disorder. Precise screening of coagulation factors is essential for diagnosis of persisting postpartum hemorrhage.


Special issues in the etiologies and treatments of sexual problems among gay men.
Some of the special circumstances and issues involved in both the causes and treatments of sexual problems among gay men are discussed. Reported frequencies of specific dysfunctions are discussed, and desire, arousal, and orgasmic phases are used to describe the special problems gay men have. These categories are also used to explore some of the probable contributing factors and specific treatment issues and suggestions that have been found useful. Since there is some indication that inhibited ejaculation is a somewhat frequent problem among gay men and has been more difficult than some dysfunctions to treat, emphasis has been placed on possible causes and treatments that have been helpful. A category of sexually inexperienced gay men is also discussed.


Adenosplenomegaly and prognosis in uncomplicated and complicated chronic lymphocytic leukemia. A study of 362 cases.
Presence and size of lymph nodes and spleen, graded from 0 to , in 362 patients with CLL observed from diagnosis were evaluated. Statistical analysis showed a relationship with age, sex, anemia and thrombopenia, leukocytosis, and outlined two different groups: the one without organomegalies , with higher mean age (67 years), female prevalence, and better prognosis; the other with adenosplenomegaly graded ++/ , with lower mean age (57 years), clear male prevalence, and worse prognosis. Survival results were statistically different only between groups 0/+ versus group ++/ . Important chronic diseases were present at diagnosis in approximately 25% of the cases, with a severely reduced survival (median, 27 months), close to that of the cases with anemia and/or thrombopenia (22 months). Therefore it seems that in every prognostic grouping system, complicated cases should be taken into account and grouped with the anemic and/or the thrombopenic ones. The following prognostic groups are proposed: I: low risk: cases without or with adenomegaly and/or splenomegaly + (65% surviving at 100 months); II: intermediate risk: cases with adenomegaly and/or splenomegaly ++/ (median survival, 70 months); III: high risk: cases complicated by chronic diseases, or with anemia and/or thrombopenia (median survival, 25 months).


Synthesis and electric field actuation of an ionic liquid polymer.
Polymerizable ionic liquids and their actuation in an electric field are a combination of material and properties with unique potential to display structural and fluid dynamics above that found in small molecule ionic liquids. In an effort to blend ionic liquid nature with actuation response, we have synthesized a new ionic liquid ammonium sulfonate monomer and polymer. The liquid temperature ranges of both the monomer and polymer ionic liquid systems are quite large extending from their respective glass transitions (Tg) of -57 and -49 degrees C to decomposition at approximately 200 degrees C. Particularly remarkable is the small Tg increment that accompanies the transformation from monomer to polymer. The electrowetting behavior of the polymer and of the monomer presents an interesting contrast. This communication will encompass the polymerization, characterization, and actuation of these new ionic liquids.


Palatal Radicular Groove Morphology of the Maxillary Incisors: A Case Series Report.
Teeth with a palatal radicular groove are challenging to diagnose, treat, and save. We classified this condition using cone-beam computed tomographic (CBCT) cross-sectional configurations combined with radiographic and morphologic observations during an intentional replantation procedure to identify and analyze the characteristics of palatal radicular grooves comprehensively as a reference for diagnosis, treatment planning, and prognosis evaluation of this condition. Eight cases with palatal radicular grooves present in permanent maxillary incisors were investigated by radiography and CBCT imaging before intentional replantation. The palatal radicular grooves were classified into 3 types based on groove depth and cross-sectional shape on CBCT images: type I, with a shallow groove depth, corresponding to a normal, simple, and single root canal; type II, with a medium groove depth, corresponding to a C-shaped canal system; and type III, with a deep groove depth, almost bisecting the root of the tooth, simultaneously present with 2 independent root canals and an apex with normal shape, corresponding to a labial groove connecting with a palatal groove. The extracted teeth and their radiographic images showed corresponding characteristics. The CBCT cross-sectional images allowed the best visualization of the depth of the grooves and highlighted the difficulties entailed in treating such teeth. Intentional replantation is an effective therapeutic decision for this type of deformity and can provide better prognosis estimation, especially in teeth with type II and III grooves.


Responses of flea beetle Phyllotreta cruciferae to synthetic aggregation pheromone components and host plant volatiles in field trials.
Male-specific compounds, previously identified from Phyllotreta cruciferae and synthesized or isolated from natural sources, attracted both sexes of the beetle in field trials and therefore function as components of a male-produced aggregation pheromone. Six field experiments of 7 to 10 d duration each were conducted over 2 yr using modified boll weevil traps and two doses of pheromone. Treatments containing two doses of allyl isothiocyanate (AITC), a breakdown product of glucosinolates in Brassica napus L., a host plant of the beetles, were included in the study. A dose response was observed for both the pheromone components and AITC, and combinations of the pheromone and AITC generally attracted greater numbers of flea beetles than did either component itself. This increased attraction to a combination of beetle-produced compounds and host odors has not been previously demonstrated in halticine beetles and could help explain patterns of movement by P. cruciferae into field crops.


VISUALIZATION OF AIRWAY.
The author provides an overview of the history of optical instruments for airway management in anesthesiology. It systematically demonstrates the development of laryngoscope down to the present time when video laryngoscope has been introduced in clinical practice.


Interrelationships between hormones, behavior, and affect during adolescence: complex relationships exist between reproductive hormones, stress-related hormones, and the activity of neural systems that regulate behavioral affect. Comments on part III.
Adolescence is a period in life marked by change, encompassing physiological changes associated with pubertal development, changes in social status and the social stresses that an individual faces, and changes in behavioral affect regulation. The interactions between activity in the reproductive axis, the neural systems that regulate stress, hormones produced in response to stress, and neural systems governing behavioral affect regulation are complex and multifaceted. Although our understanding of these interactions remains rudimentary, we do know that stress can suppress activity of the reproductive axis, that reproductive hormones can modulate the activity of neural systems that govern the body's responses to stress, that both reproductive function and stress responsiveness can be altered in depressed individuals, and that the function of some of the key neural systems regulating behavioral affect (i.e., serotonergic, noradrenergic, dopaminergic systems) are modulated by both gonadal steroid hormones and adrenal steroid hormones. This summary reviews the central interactions discussed in this session on the interrelationships between hormones, behavior, and affect during adolescence and identifies key topics that require further investigation in order to understand the role that pubertal changes in reproductive function, interacting with increased exposure to life stresses, play in modulating behavioral affect regulation during the adolescent period.


The Montreux definition of neonatal ARDS: biological and clinical background behind the description of a new entity.
Acute respiratory distress syndrome (ARDS) is undefined in neonates, despite the long-standing existing formal recognition of ARDS syndrome in later life. We describe the Neonatal ARDS Project: an international, collaborative, multicentre, and multidisciplinary project which aimed to produce an ARDS consensus definition for neonates that is applicable from the perinatal period. The definition was created through discussions between five expert members of the European Society for Paediatric and Neonatal Intensive Care; four experts of the European Society for Paediatric Research; two independent experts from the USA and two from Australia. This Position Paper provides the first consensus definition for neonatal ARDS (called the Montreux definition). We also provide expert consensus that mechanisms causing ARDS in adults and older children-namely complex surfactant dysfunction, lung tissue inflammation, loss of lung volume, increased shunt, and diffuse alveolar damage-are also present in several critical neonatal respiratory disorders.


Bayesian structural time series for biomedical sensor data: A flexible modeling framework for evaluating interventions.
The development of mobile-health technology has the potential to revolutionize personalized medicine. Biomedical sensors (e.g., wearables) can assist with determining treatment plans for individuals, provide quantitative information to healthcare providers, and give objective measurements of health, leading to the goal of precise phenotypic correlates for genotypes. Even though treatments and interventions are becoming more specific and datasets more abundant, measuring the causal impact of health interventions requires careful considerations of complex covariate structures, as well as knowledge of the temporal and spatial properties of the data. Thus, interpreting biomedical sensor data needs to make use of specialized statistical models. Here, we show how the Bayesian structural time series framework, widely used in economics, can be applied to these data. This framework corrects for covariates to provide accurate assessments of the significance of interventions. Furthermore, it allows for a time-dependent confidence interval of impact, which is useful for considering individualized assessments of intervention efficacy. We provide a customized biomedical adaptor tool, MhealthCI, around a specific implementation of the Bayesian structural time series framework that uniformly processes, prepares, and registers diverse biomedical data. We apply the software implementation of MhealthCI to a structured set of examples in biomedicine to showcase the ability of the framework to evaluate interventions with varying levels of data richness and covariate complexity and also compare the performance to other models. Specifically, we show how the framework is able to evaluate an exercise intervention's effect on stabilizing blood glucose in a diabetes dataset. We also provide a future-anticipating illustration from a behavioral dataset showcasing how the framework integrates complex spatial covariates. Overall, we show the robustness of the Bayesian structural time series framework when applied to biomedical sensor data, highlighting its increasing value for current and future datasets.


Increased injuries on night shift.
Concern over safety has resulted in legislation by, for example, the Commission of the European Union, to limit the number of hours worked at night. There is, however, no direct evidence that injuries are more frequent at night. We analysed all 4645 injury incidents reported for a year on a rotating three-shift system in a large engineering company where the a-priori accident risk appeared to be constant. The relative risk of sustaining an injury was 1.23 (95% CI 1.14-1.31) higher on the night shift than on the morning shift, which showed the lowest incidence. The type of work (machine versus self-paced) affected the pattern and nature of injuries; for self-paced work the relative risk of more serious injury on the night shift compared with the morning shift was 1.82 (1.30-2.34).


Insulin Treatment of Hypertriglyceridemia During Pregnancy.
Objective: This study aims to investigate the efficiency of insulin on the reduction of gestational lipid profiles and try to propose a real-world approach to assist clinicians. Methods: A retrospective, single-centered cohort study of 35 cases was conducted from October 2018 to July 2021 in Shanghai General Hospital. SPSS version 25.0 was performed to analyze the whole data. For continuous variables, a paired-sample t test was carried out on each variable to make a comparison between before and after treatment. Results: The average pre-pregnancy TGs and TCs of these patients were about 3.96 ± 1.42 mmol/L and 4.78 ± 1.18 mmol/L, respectively. The maximum of TG before insulin treatment was up to 64.62 and TC 20.43 mmol/L, which decreased to 17.34 and 4.92 mmol/L after intervention of the insulin drip. TG was noticed to fall by 77% and 12.71% of TG, respectively. The difference of TG and TC between pre-treatment and post-treatment were statistically significant (p < 0.01), while this difference has not been found in the other laboratory tests reports. The outcomes of newborns and mothers with management of insulin were proven to be improved. Conclusion: The use of insulin in the management of gestational hypertriglyceridemia is safe and efficient, and insulin may become a mainstream in the near future to mitigate serum TG and TC levels in the pregnancy period besides regulating the blood glucose level.


Cell-to-cell communication and myogenesis.
Cell-to-cell communication was characterized in prefusion chick embryo myoblast cultures, and it was determined that the prefusion myoblasts can interact via gap junctions, ionic coupling, and metabolic coupling. The biological relevance of this communication was supported by the detection of gap junctions between myoblasts in embryonic muscle. Communication was also examined in fusion-arrested cultures to determine its potential relationship to fusion competency. In cultures that were fusion arrested by treatment with either 1.8 mM ethyleneglycolbis-(beta-aminoethyl ether)N,N'-tetraacetic acid (EGTA), 3.3 X 10(-6) M 5-bromodeoxyuridine (BUdR), or 1 microgram/ml cycloheximide (CHX), both gap junctions and ionic coupling were present. Therefore, it is possible to conclude that cell communication is not a sufficient property by itself, to generate fusion between myob-asts. The potential role of communication in myogenesis is discusssed with respect to these observations.


Glucosylation of Ras by Clostridium sordellii lethal toxin: consequences for effector loop conformations observed by NMR spectroscopy.
The lethal toxin (LT) from Clostridium sordellii, which belongs to the family of large clostridial cytotoxins, acts as a monoglucosyltransferase for the Rho subfamily GTPase Rac and also modifies Ras. In the present study we investigated structural changes of H-Ras in its di- and triphosphate form that occur upon glucosylation of the effector domain amino acid threonine-35 by LT. (31)P NMR experiments recorded during the enzymatic glucosylation process, using UDP-glucose as a cosubstrate, show that the modification of the threonine side chain influences the chemical shifts of the phosphate groups of the bound nucleotides. In the diphosphate-bound form (Ras.GDP) glucosylation of Thr35 induces only small changes in the chemical environment of the active center. In the triphosphate form with the GTP analogue GppNHp bound (Ras.GppNHp) Ras shows at least two different conformations in the active center that exchange on a medium-range time scale (10 to 0.1 ms). Glucosylation selectively stabilizes one distinct conformation of the effector loop (state 1) with tyrosine-32 probably apart from the nucleotide and threonine-35 not involved in magnesium ion coordination. This conformation is known to have a low affinity to effector proteins such as Raf-1, AF-6, or Byr2 and thus prevents the transduction of the activation signal in the Ras-mediated pathway. NMR correlation spectra of Ras(T35glc).GDP and denaturation experiments with urea indicate that the glucose is bound in the alpha-anomeric form to the hydroxyl group of the threonine-35 side chain. Inhibition of the glucosylation reaction by 1,5-gluconolactone suggests a stereospecific reaction mechanism with a glucosyl oxonium ion transition state for the enzymatic activity of LT.


Lactobacillus co-fermentation of Cerasus humilis juice alters chemical properties, enhances antioxidant activity, and improves gut microbiota.
Fermentation with Lactobacillus has been shown to improve the nutritional value of juice. In this study, Cerasus humilis juice was fermented using two commercial probiotics, namely, Lactobacillus acidophilus and Lactobacillus plantarum. The total antioxidant capacity (TAOC), viable count, chemical properties, antioxidant activity after in vitro digestion, and alterations in the gut microbiota composition of the fermented juice were investigated. After fermentation, the TAOC increased from 107.66 U mL-1 to 126.72 U mL-1; viable count increased from 5.85 lg (CFU mL-1) to 8.17 lg (CFU mL-1); and the contents of total phenols, total flavonoids, proanthocyanins, four organic acids, and 29 amino acids had changed. Overall, 47 compounds were identified in the juice, 20 of which were enriched after fermentation. Furthermore, Lactobacillus co-fermentation improved the antioxidant properties of the juice after in vitro digestion and increased the abundance of probiotics to regulate the gut microbiota. These findings illustrate the potential use of Lactobacillus acidophilus and Lactobacillus plantarum in the co-fermentation of C. humilis juice to enhance its nutritional and functional properties.


Video Capture of Perforator Flap Harvesting Procedure with a Full High-definition Wearable Camera.
Recent advances in wearable recording technology have enabled high-quality video recording of several surgical procedures from the surgeon's perspective. However, the available wearable cameras are not optimal for recording the harvesting of perforator flaps because they are too heavy and cannot be attached to the surgical loupe. The Ecous is a small high-resolution camera that was specially developed for recording loupe magnification surgery. This study investigated the use of the Ecous for recording perforator flap harvesting procedures. The Ecous SC MiCron is a high-resolution camera that can be mounted directly on the surgical loupe. The camera is light (30 g) and measures only 28 × 32 × 60 mm. We recorded 23 perforator flap harvesting procedures with the Ecous connected to a laptop through a USB cable. The elevated flaps included 9 deep inferior epigastric artery perforator flaps, 7 thoracodorsal artery perforator flaps, 4 anterolateral thigh flaps, and 3 superficial inferior epigastric artery flaps. All procedures were recorded with no equipment failure. The Ecous recorded the technical details of the perforator dissection at a high-resolution level. The surgeon did not feel any extra stress or interference when wearing the Ecous. The Ecous is an ideal camera for recording perforator flap harvesting procedures. It fits onto the surgical loupe perfectly without creating additional stress on the surgeon. High-quality video from the surgeon's perspective makes accurate documentation of the procedures possible, thereby enhancing surgical education and allowing critical self-reflection.


Characteristics of a spoiled 6-MV beam from a dual-energy linear accelerator.
A beam spoiler for a 6-MV x-ray beam was designed and spoiled beam dosimetry performed. The spoiled beam quality was similar to that of the unspoiled beam. The percentage depth doses at 5 mm were at least 90% for all field sizes except 4 x 4 cm, while the surface dose at 0 mm varied from 22.5% for a 4 x 4-cm field to 85.8% for a 22 x 22-cm field. The spoiled beam showed degraded beam flatness for small field size at superficial depths; the beam flatness at 6 mm for a 4 x 4-cm field was +/- 9.0%. The beam flatness improved as the field size increased, e.g., at same depth, the beam flatness was +/- 2.5% for a 22 x 22-cm field. The penumbra width (90%-10%) of the spoiled beam was greater than that of the unspoiled beam for all field sizes and at all depths; e.g., at 0-mm depth, for a 22 x 22-cm field, the penumbra width was 3.8 cm for the unspoiled beam and 7.2 cm for the spoiled beam. Beyond dmax the difference in the penumbra widths between the spoiled and unspoiled beam was about 3-4 mm for all field sizes and at all depths. The peripheral dose was larger for the spoiled beam.


A simple method for safe identification of the facial nerve using palpable landmarks.
External palpable landmarks can be used to identify the facial nerve trunk quickly and safely. Prospective anatomical dissection study. University department of human anatomy and university hospital. A total of 40 human cadaver heads (79 facial nerves) were dissected by 2 prosectors, a surgeon with experience in the anatomy of the parotid region (J.A.P.; n = 39) and a medical student with experience in anatomical dissection and basic knowledge of the facial nerve disposition (A.M.; n = 40). A 3-cm skin incision was made in the center of the triangle formed by the temporomandibular joint, the mastoid process, and the angle of the mandible, and dissection was continued deep until the main facial nerve trunk was identified. The time taken from the skin incision to the identification of the nerve was monitored with a chronometer by an independent observer. The distance between the predicted and actual position of the facial nerve was measured. In all cases, the facial nerve was identified and there were no significant differences in the dissection time between the 2 prosectors (144 vs 148 seconds). The mean distance between the predicted and the actual position of the nerve was 1.42 mm. The proposed localization landmarks allowed a fast and safe identification of the facial nerve and may be of significant help during surgery around the parotid region.


Impact of Cl Doping on Electrochemical Performance in Orthosilicate (Li2FeSiO4): A Density Functional Theory Supported Experimental Approach.
Safe and high-capacity cathode materials are a long quest for commercial lithium-ion battery development. Among various searched cathode materials, Li2FeSiO4 has taken the attention due to optimal working voltage, high elemental abundance, and low toxicity. However, as per our understanding and observation, the electrochemical performance of this material is significantly limited by the intrinsic low electronic conductivity and slow lithium-ion diffusion, which limits the practical capacity (a theoretical value of ∼330 mAh g-1). In this report, using first-principles density functional theory based approach, we demonstrate that chlorine doping on oxygen site can enhance the electronic conductivity of the electrode and concurrently improve the electrochemical performance. Experimentally, X-ray diffraction, X-ray photoelectron spectroscopy, and field-emission gun scanning electron microscopy elemental mapping confirms Cl doping in Li2-xFeSiO4-xClx/C (x ≤ 0.1), while electrochemical cycling performance demonstrated improved performance. The theoretical and experimental studies collectively predict that, via Cl doping, the lithium deinsertion voltage associated with the Fe2+/Fe3+ and Fe3+/Fe4+ redox couples can be reduced and electronic conductivity can be enhanced, which opens up the possibility of utilization of silicate-based cathode with carbonate-based commercial electrolyte. In view of potential and electronic conductivity benefits, our results indicate that Cl doping can be a promising low-cost method to improve the electrochemical performance of silicate-based cathode materials.


Wound infection following cesarean section.
To investigate a high incidence of wound infections occurring in patients following cesarean section at a 650 bed charity hospital in Louisiana, a bacteriologic investigation was carried out. In this study, cultures were made at multiple sites prior to operation. An attempt was made to identify those bacteria that were predominately responsible for wound infection and their source, whether from the patient herself or from a nosocomial origin. The patients were divided into three groups depending on the degree of postoperative morbidity that followed. The bacterial flora in each group was relatively the same. Other factors were more significant in predicting those patients in whom postoperative morbidity occurred.


On the use of genetic programming for mining comprehensible rules in subgroup discovery.
This paper proposes a novel grammar-guided genetic programming algorithm for subgroup discovery. This algorithm, called comprehensible grammar-based algorithm for subgroup discovery (CGBA-SD), combines the requirements of discovering comprehensible rules with the ability to mine expressive and flexible solutions owing to the use of a context-free grammar. Each rule is represented as a derivation tree that shows a solution described using the language denoted by the grammar. The algorithm includes mechanisms to adapt the diversity of the population by self-adapting the probabilities of recombination and mutation. We compare the approach with existing evolutionary and classic subgroup discovery algorithms. CGBA-SD appears to be a very promising algorithm that discovers comprehensible subgroups and behaves better than other algorithms as measures by complexity, interest, and precision indicate. The results obtained were validated by means of a series of nonparametric tests.