[Nicolas Puzos: an obstetrician of the 18th century. From military surgery to obstetrics and from milk fever to placenta praevia].
Nicolas Puzos (1686-1753) was a famous french obstetrician in Paris during the 18th century. When he was sixteen years old, his father sent him as aide-major to follow the armies of Louis XIV to learn military surgery. After this he became an obstetrician studying with his master, a friend of his father, Julien Clément, accoucheur to the Court. Puzos while working wrote many notes which were assembled in a book after his death by Morisot-Deslandes: "Traité des Accouchements de M. Puzos", published in 1759. Puzos was the first to advocate rupture and tearing of the membranes in the treatment of haemorrhage brought about by placenta praevia partialis or marginalis. This "Puzos' method" as it is even now sometimes called in France, was aimed to replace "accouchement forcé" followed by version and was discussed by Leroux of Dijon who advocated the vaginal pack or tamponade. The "Puzos' method" was adopted until the current use of cesarean section.


Epidemiology of injury and the impact of health disparities.
The purpose of this review is to highlight recent advances in understanding the epidemiology of pediatric trauma and the impact of health disparities on care of the injured child. Recent studies examining outcomes for injury in children consistently demonstrate worse clinical and functional outcomes for minority children compared with white children, with African-American race being an independent predictor of mortality. Despite controlling for injury severity and insurance status (as a surrogate of socioeconomic status), these disparities persist. Significant racial differences in mortality were also identified when national data were compared with local institutional data for children with traumatic brain injury. Studies examining the effect of insurance status on care of the injured child have similarly uncovered unsettling inequities. Disparities in delivery of pediatric trauma care have been identified based on access to pediatric trauma centers. Other studies have sought to reduce disparities by use of guidelines. Finally, prevention studies have demonstrated racial disparities in the use of motor vehicle restraints, with improved restraint use in minority populations after implementation of culturally tailored prevention programs. The cause of disparities in childhood trauma appears to be multifactorial and may include race, socioeconomic factors, insurance status, access, and healthcare provider biases. Multiple studies have confirmed that disparities exist, but it is difficult to tease out the reasons why they exist. Further work is necessary to identify causes of such disparities and formulate strategies to eliminate them.


Factors affecting condom use among senior secondary school pupils in South Africa.
The aim of the study was to investigate factors affecting condom use among senior secondary school pupils in South Africa. Objectives were to identify the sociodemographic characteristics and sexual history, knowledge about correct condom use, source of condom information, AIDS health beliefs, self efficacy of condom use, correlates and predictors of condom use in Grade 12 students. Cross sectional survey. 460 Grade 12 secondary school pupils from three rural schools. The sample included 460 Grade 12 secondary school pupils, 170 (37%) males and 290 (63%) females in the age range of 16 to 30 years (mean age 19.7 yrs, SD = 2.5). Self reported sexual activity and condom use (12 items); source of 'condom' information (12 items); knowledge of correct condom use (10 items); a 16 item AIDS Health Belief Scale and a 28 item Condom Use Self-Efficacy Scale. About half of those sexually active (52.6% males and 40.5% females) reported never having used condoms. About 90% levels of correct answers on condom knowledge were found for the items of "protection against AIDS" and "expire date of condoms". Knowing someone with HIV/AIDS was related to current condom use and a history of STD with lifetime condom use. The four AIDS beliefs sub-scales were all related to self efficacy of condom use. Behavioural norm to use condoms, attitudes towards condom use, normative beliefs to use of condoms and subjective norm to use condoms were all related to condom use intention. Normative beliefs and subjective norms to use condoms were both negatively related with lifetime condom use, current condom use, and self efficacy in condom use. Normative beliefs, attitudes and subjective norms about condoms predicted condom use intention, AIDS susceptibility and AIDS benefits predicted condom use with last sexual partner, and AIDS benefits and AIDS barriers predicted condom use intention. Findings have relevant implications and are discussed in the context of developing an educational or intervention programme.


Comparison of progenitor cell content in sequential peripheral blood progenitor collections after mobilization with chemotherapy and granulocyte macrophage colony-stimulating factor.
Optimal timing of peripheral blood progenitor cell (PBPC) harvest to collect maximal stem cell numbers is unknown. We assessed the progenitor cell content in 128 PBPC harvests from 21 patients primed with chemotherapy and granulocyte macrophage-colony stimulating factor (GM-CSF) in relation to absolute neutrophil count (ANC) at collection time. Samples were obtained by leukapheresis during rebound from chemotherapy-induced neutropenia while receiving GM-CSF, and assayed by flow cytometry for CD34+ and by colony assays for CFU-GM and BFU-E. The CD34+ cell concentrations per sample tended to be greater at an ANC < 1,000 mm3 and decreased with rising ANC (p = 0.001). The CFU-GM and BFU-E concentrations per sample remained relatively constant with rising ANC (p = 0.72, p = 0.90, respectively). Total CD34+ cell number per harvest per kg slightly increased with ANC levels (p = 0.044) whereas the total CFU-GM and the total BFU-E per kilogram increased more modestly with rising ANC (p < 0.001, p < 0.001, respectively). We conclude that after priming with chemotherapy and GM-CSF, PBPC could be collected at different absolute neutrophil counts without greatly affecting total CD34+ cell numbers. The greater concentration of CD34+ progenitor cells at a lower ANC together with the CFU-GM and BFU-E peaking with higher ANC suggest a less mature progenitor cell population at lower ANC levels.


Measurement of the temperature profile of an exothermic autocatalytic reaction front.
Autocatalytic reactions may propagate as solitary waves, namely, at a constant front velocity and with a stationary concentration profile, resulting from a balance between molecular diffusion and chemical reaction. When the reaction is exothermic, a thermal wave is linked to the chemical front. As the thermal diffusivity is nearly two orders of magnitude larger than the molecular one, the temperature profile spreads over length scales (mm) two orders of magnitude larger than the concentration one. Using an infrared camera, we measure the temperature profiles for a chlorite-tetrathionate autocatalytic reaction. The profiles are compared quantitatively to lattice Bhatnagar-Gross-Krook (BGK) numerical simulations. Our analysis also accounts for the lack of observation of the thermal wave for the iodate arsenous acid reaction.


Medicaid managed care penetration and drug utilization for patients with serious mental illness.
State Medicaid programs are under increasing pressure to contain pharmaceutical spending. Many states have attempted to limit spending through greater Medicaid managed care penetration, which rose nationally from 54.5% in 1999 to 74.9% in 2011. It is not clear how this expansion has affected beneficiaries with serious mental illness (SMI)-a vulnerable population that often has their drug spending "carved out" from their managed care benefit. We sought to assess the association between managed care penetration and pharmaceutical spending on drugs for SMIs in these states. Retrospective cohort study. State-year observations were constructed to study the relationship between managed care penetration and pharmaceutical spending on drugs for SMIs over the period 1999 to 2011. We analyzed the relationship using both cross-sectional and panel-data methods. Our cross-sectional analyses suggested that carve-out states with greater managed care penetration spend significantly less per enrollee on pharmaceuticals for the treatment of mental disorders: our panel data analyses did not generate statistically meaningful results. Future studies should address whether any effects of managed care on mental health prescription utilization and spending reflect improved care coordination or worsening access to valuable care for the population with SMI.


Complex hygrothermal effects on the glass transition of an epoxy-amine thermoset.
Anomalous hygrothermal behavior in an epoxy-amine thermoset was observed in terms of increases in glass-transition temperatures (T(g)) after immersion in water at different temperatures. Fourier transform near-infrared (FT-NIR) spectroscopic measurements showed that an increase in conversion was responsible for the increase in glass transition, while plasticization occurred simultaneously, rendering the hygrothermal behavior to be complex. To consider other factors affecting this complex hygrothermal behavior, a relationship between T(g) and conversion was constructed for the unexposed system and compared to the corresponding T(g) values for the exposed system at the same point of each conversion value. With this method, the conversion was successfully excluded to compare the T(g) values directly between the unexposed and exposed systems. This indicates the effects of other factors are negligible compared with the large plasticization effect. The plasticization effect was also evaluated quantitatively by observing T(g) differences between the unexposed and the exposed system as a function of absorbed water amount estimated by a characteristic water peak in the NIR spectra. The result indicates that there is additional anomalous behavior in which DeltaT(g) changes independently of the water amount at higher exposure temperatures.


Cancer case-control studies with other cancers as controls.
Theoretical considerations concerning the use of other cancer patients as controls in cancer case-control studies are reviewed. Selection bias may be a problem in that some other cancers may be caused by the exposure under study biasing the odds ratio towards unity. Such bias is noted to be greatest with low prevalence exposures associated with high attributable risks for other cancers. However, it may be possible to identify selection bias with other cancer controls using census or other general population data. In addition, using other cancers as controls has important advantages with regard to recall and interviewer bias, which may be of unknown magnitude and direction when using general population controls. A further disadvantage of general population controls is that separate selection of decreased controls should usually be made for deceased cases, whereas a mixture of live and deceased controls can be expected when selecting other cancer patients as controls. Since there are also logistical and cost advantages in using other cancer patients as controls, this study design is likely to be used increasingly in the future, particularly in cancer registry settings.


Alternative splicing produces transcripts encoding two forms of the alpha subunit of GTP-binding protein Go.
The alpha subunit of the guanine nucleotide-binding protein Go ("o" for other) is believed to mediate signal transduction between a variety of receptors and effectors. cDNA clones encoding two forms of Go alpha subunit were isolated from a mouse brain library. These two forms, which we call GoA alpha and GoB alpha, appear to be the products of alternative splicing. GoA alpha differs from GoB alpha over the C-terminal third of the deduced protein sequence. Both forms are predicted to be substrates for ADP-ribosylation by pertussis toxin. GoA alpha transcripts are present in a variety of tissues but are most abundant in brain. The GoB alpha transcript is expressed at highest levels in brain and testis. It is possible that GoA alpha and GoB alpha have different functions.


Mistaken diagnosis of psychogenic gait disorder in a man with status cataplecticus ("limp man syndrome").
We report on a 45-year-old man with a history of multiple psychiatric admissions for a gait disorder and episodic weakness thought to be psychogenic who was subsequently diagnosed with status cataplecticus due to narcolepsy. The gait difficulties resolved with venlafaxine. This case demonstrates that status cataplecticus can be misdiagnosed as a psychogenic gait disorder.


Neuroblastoma: the Joint Center for Radiation Therapy/Dana-Farber Cancer Institute/Children's Hospital experience.
The treatment results for 118 patients with neuroblastoma seen at the Joint Center for Radiation Therapy/Dana-Farber Cancer Institute/Children's Hospital from 1970 to 1980 were analyzed. Patients were treated with a combination of surgery, radiation therapy, and chemotherapy depending on stage and age. Disease-free survival was excellent in all patient groups except those over one year of age with stage IV disease, a group for which currently available therapy cures only a small proportion of patients. Patients with stage III disease and older patients with stage II disease did extremely well (survival of 81% and 89%, respectively) and may have benefited from intensive treatment with all three modalities. Survival for infants (under one year) with stage IV neuroblastoma (90%) has clearly improved with intensive combination chemotherapy. With combination approaches and newer, more effective systemic regimens, a real impact on survival appears to have been made in the last decade. Better approaches will be necessary to cure more than an occasional older patient with stage IV disease.


Sensitive Chemiluminescent Sensing Method for Mercury(II) Ions Based on Monolayer Molybdenum Disulfide.
A simple and sensitive chemiluminescent (CL) sensing platform for mercury(II) ions (Hg2+) in water was developed based on monolayer molybdenum disulfide (MoS2). The layered MoS2 can catalyze the oxidation of luminol by H2O2, producing an enhanced CL signal because of the peroxidase-like activity of the layered MoS2. In addition, MoS2 has a good adsorption ability to Hg2+ because of the inherent affinity of Hg2+ to sulfur contained in MoS2. Interestingly, the pre-incubation of Hg2+ with layered MoS2 inhibited the catalytic activity of MoS2 on the luminol-H2O2-MoS2 CL reaction, leading to CL quenching. The CL intensity decreased linearly with increasing concentration of Hg2+ from 0.005 - 40 μM. The limit of detection (LOD) was estimated to be 1 nM. The relative standard deviation (RSD) was found to be 3.71%, indicating good reproducibility. The recoveries of Hg2+ spiked in tap water were from 100.0 to 116.0% with RSD from 2.7 to 5.6%, detected by the standard addition method, and demonstrated good applicability.


Characterization of vaginal flora and bacterial vaginosis in women who have sex with women.
Bacterial vaginosis (BV) may be common among women who report having sex with women (WSW) and frequently occurs in both members of monogamous couples. The results of Gram staining of a vaginal smear were consistent with BV in 81 (25%) and intermediate in 37 (11%) of 326 WSW included in this study. Lactobacilli were detected in 64% of subjects, and 42% of subjects had H(2)O(2)-producing strains. BV was associated with a higher lifetime number of female sex partners, failure to always clean an insertive sex toy before use, and oral-anal sex with female partners. Neither recent douching nor sexual practices with male partners were associated with BV. Vaginal smears from each partner were concordant in 55 (95%) of 58 monogamous couples; BV was present in both partners in 16 couples (28%) (P<.001, compared with expected distribution). BV was common among subjects who did not douche, who did not have concurrent sex with male partners, or who did not have a new sex partner, which suggests that other risk factors for BV exist. These data support the hypothesis that sexual exchange of vaginal secretions is a possible mechanism for acquisition of BV.


Atypical centrioles are present in Tribolium sperm.
Typical centrioles are made of microtubules organized in ninefold symmetry. Most animal somatic cells have two centrioles for normal cell division and function. These centrioles originate from the zygote, but because the oocyte does not provide any centrioles, it is surprising that the zygotes of many animals are thought to inherit only one centriole from the sperm. Recently, in the sperm of Drosophila melanogaster, we discovered a second centriolar structure, the proximal centriole-like structure (PCL), which functions in the zygote. Whether the sperm of other insects has a second centriolar structure is unknown. Here, we characterized spermiogenesis in the red flour beetle, Tribolium castaneum Electron microscopy suggests that Tribolium has one microtubule-based centriole at the tip of the axoneme and a structure similar to the PCL, which lacks microtubules and lies in a cytoplasmic invagination of the nucleus. Immunostaining against the orthologue of the centriole/PCL protein, Ana1, also recognizes two centrioles near the nucleus during spermiogenesis: one that is microtubule-based at the tip of the axoneme, suggesting it is the centriole; and another that is more proximal and appears during early spermiogenesis, suggesting it is the PCL. Together, these findings suggest that Tribolium sperm has one microtubule-based centriole and one microtubule-lacking centriole.


The incidence and impact of recurrent workplace injury and disease: a cohort study of WorkSafe Victoria, Australia compensation claims.
To determine the incidence and impact of recurrent workplace injury and disease over the period 1995-2008. Population-based cohort study using data from the state workers' compensation system database. State of Victoria, Australia. A total of 448 868 workers with an accepted workers' compensation claim between 1 January 1995 and 31 December 2008 were included into this study. Of them, 135 349 had at least one subsequent claim accepted for a recurrent injury or disease during this period. Incidence of initial and recurrent injury and disease claims and time lost from work for initial and recurrent injury and disease. Over the study period, 448 868 workers lodged 972 281 claims for discrete occurrences of work-related injury or disease. 53.4% of these claims were for recurrent injury or disease. On average, the rates of initial claims dropped by 5.6%, 95% CI (-5.8% to -5.7%) per annum, while the rates of recurrent injuries decreased by 4.1%, 95% CI (-4.2% to -0.4%). In total, workplace injury and disease resulted in 188 978 years of loss in full-time work, with 104 556 of them being for the recurrent injury. Recurrent work-related injury and disease is associated with a substantial social and economic impact. There is an opportunity to reduce the social, health and economic burden of workplace injury by enacting secondary prevention programmes targeted at workers who have incurred an initial occupational injury or disease.


Do reflex comments on laboratory reports alter patient management?
Laboratory comments appended on clinical biochemistry reports are common in the UK. Although popular with clinicians and the public, there is little evidence that these comments influence the clinical management of patients. We provided reflex automated laboratory comments on all primary care lipid results including, if appropriate, recommendation of direct referral to the West Midlands Familial Hypercholesterolaemia service (WMFHS). Over a two-year period, the number GP referrals from the Wolverhampton City Clinical Commissioning Group (CCG) to the WMFHS were compared with four comparator CCGs of similar population size, who were not provided with reflex laboratory comments. Over the study period, the WMFHS received more referrals from Wolverhampton GPs (241) than any other comparator CCG (range 8-65) and greater than the combined referrals (172) from all four comparator CCGs. Targeted reflex laboratory comments may influence the clinical management of patients and may have a role in the identification of individuals with familial hypercholesterolaemia.


Evaluating 90Y-glass microsphere treatment response of unresectable colorectal liver metastases by [18F]FDG PET: a comparison with CT or MRI.
The purpose of this prospective study was to evaluate yttrium-90 glass microsphere treatment of unresectable liver metastases by fluorine-18 fluorodeoxyglucose positron emission tomography ([18F]FDG PET), and to compare the effectiveness of [18F]FDG PET for this purpose with that of computed tomography (CT) or magnetic resonance imaging (MRI) and determination of the serum carcinoembryonic antigen (CEA) level. Thirteen hepatic lobes from eight consecutive patients with colorectal cancer referred for 90Y-glass microsphere treatment of unresectable liver metastases who underwent both baseline (pretreatment) and 3-month posttreatment PET were studied. All patients also had correlative pre- and posttreatment CT or MRI for evaluation of the anatomic response and serum CEA determination for assessment of the total tumor load, as well as pretreatment hepatic intra-arterial technetium-99m macroaggregated albumin scan for lung shunting evaluation and hepatic arteriography for assessment of vascular anatomy and treatment. 90Y-glass microspheres were infused via an intra-arterial catheter under low pressure. Dedicated whole-body PET scans were analyzed visually and compared by lesion and by lobe with CT or MRI. A metabolic response after 90Y treatment to single or both hepatic lobes, assessed by PET, was present in a significantly higher proportion of the lobes than was an anatomic response, evaluated by CT or MRI (12 vs 2 lobes respectively, P<0.0002). Posttreatment PET showed no, stable, progressive, and new extrahepatic metastases in two, three, one, and two patients respectively. Following treatment, serum CEA decreased significantly, correlating with PET but not with CT or MRI. Thus, the study demonstrated a significant difference between the metabolic and the anatomic response after 90Y-glass microsphere treatment for unresectable liver metastases in colorectal cancer. PET appears to be an accurate indicator of treatment response.


[Indication for spinal anesthesia for cesarean section in HELLP syndrome coagulopathy].
We describe the relation between coagulation and local-regional anesthesia in two women with HELLP syndrome who required emergency cesarean delivery. HELLP syndrome involves hemolysis, elevated liver enzyme levels and thrombopenia complicating the hypertension of pregnancy. Regional anesthesia presents advantages for mother and fetus in this context but also involves the risk of coagulopathy. In the first case we describe, coagulation was normal before surgery and epidural anesthesia was therefore prescribed. The initial epidural puncture was hemorrhagic and a second, higher puncture was made to insert the catheter. Shortly after surgery severe thrombopenia developed and lasted 24 hours; formation of an epidural hematoma caused by vascular lesion during puncture was suspected. The epidural catheter was left in place, and the patient was kept under observation and seen by a neurologist within the first 48 hours. Outcome was good. In the second patient, epidural puncture was contraindicated by the presence of preoperative coagulopathy, and the cesarean was performed without complications under intradural anesthesia provided with low doses of bupivacaine and fentanyl. The coagulopathy that accompanies HELLP syndrome should be assessed not only before taking the decision on anesthetic technique; as the condition can be progressive it can become most severe after the epidural puncture is performed, as shown by the first case we describe. The patient's condition must be watched closely until coagulation becomes normal. Removal of the epidural catheter must wait until coagulopathy is resolved. When coagulopathy is evident before surgery, intradural anesthesia is a safe option provided hemodynamic stability is assured, as demonstrated by the second case we report.


The effect of paraffin wax embedding procedures on the ability of the fluorescent antibody test to demonstrate bluetongue virus antigen in insect tissue.
The effect of the reagents used in paraffin wax embedding procedures on the fluorescent antibody technique was investigated with a view to using this test for virus location studies on paraffin wax sections of bluetongue virus infected Culicoides variipennis. Experiments were carried out using tissue smears rather than prepared sections, enabling the effect of individual reagents to be evaluated. Infected smears treated with acetone alone showed bright specific fluorescence, while treatment of infected smears with all other reagents, including low melting point wax and acetone-soluble ester wax, prior to immunofluorescence testing reduced the brightness of specific fluorescence or rendered the test completely ineffective.


Terminal disinfection in hospitals wihh quaternary ammonium compounds by use of a spray-fog technique.
Spray-fogging of hospital rooms with a quarternary ammonium disinfectant was found to be an effective means of reducing the number of detectable airborne and surface bacteria. The level of bacterial contamination in hospital rooms was determined before and after fogging by means of the gravitational fallout method, the petri dish swab technique, and volumetric air-sampling procedures. Rooms vacated by patients infected with staphylococci, streptococci, pseudomonads, and salmonellae were tested and found to be effectively decontaminated of most of the detectable organisms by the fogging procedure.


Drunk driving policies and breath test refusal in Taiwan.
Driving under the influence (DUI) is one of the major causes of traffic crashes in Taiwan, leading to huge medical expenditures and human capital loss. Although the authorities have enacted several policies to reduce drunk driving, most penalties are based on drunk drivers' alcohol levels. According to Taiwan regulations, drivers could pay a fine to refuse the breath test if they are not involved in a traffic collision, and there is no clear evidence showing that they are DUI. Therefore, increased sanctions for DUI may lead to increased breath test refusals. If breath tests for drunk driving could be refused with little or no punishments for drivers, then the detection of behavioral impairment would weaken, and the deterrent effect of DUI punishment would be limited. This research uses interrupted time-series analysis (ITSA) to examine how policy reforms from 2007 to 2020 affected driver's breath refusal rate in Taiwan. We find that said reforms that exclusively increase the punishment of DUI offenders did raise the refusal rate immediately and persistently, suggesting that more drunk drivers would refuse a breath test to avoid more severe DUI punishment. Policy reforms that increase penalties for drivers refusing to take breath tests may instantly lower the refusal rate, but the long-term effects are contingent upon the DUI punishment. It appears that drunk drivers could still decide on breath test refusal to avoid a DUI conviction if the punishment for refusing the test is less severe than that for DUI. Aggravating penalties for refusing breath tests would decrease the refusal rate and help reinforce DUI's deterrent effect.


Pediatric Melanoma and Drug Development.
Importance-Pediatric melanoma occurs, albeit rarely. Should patients be treated by today's medical standards, or be subjected to medically unnecessary clinical studies? Observations-We identified international, industry-sponsored pediatric melanoma studies triggered by regulatory demands in www.clinicaltrials.gov and further pediatric melanoma studies demanded by European Union pediatric investigation plans. We retrieved related regulatory documents from the internet. We analyzed these studies for rationale and medical beneficence on the basis of physiology, pediatric clinical pharmacology and rationale. Regulatory authorities define children by chronological age, not physiologically. Newborns' organs are immature but they develop and mature rapidly. Separate proof of efficacy in underage patients is justified formally/regulatorily but lacks medical sense. Children-especially post-puberty-and adults vis-a-vis medications are physiologically very similar. Two adolescent melanoma studies were terminated in 2016 because of waning recruitment, while five studies in pediatric melanoma and other solid tumors, triggered by European Union pediatric investigation plans, continue recruiting worldwide. Conclusions and Relevance-Regulatory-demanded pediatric melanoma studies are medically superfluous. Melanoma patients of all ages should be treated with effective combination treatment. Babies need special attention. Children need dose-finding and pharmacokinetic studies but adolescents metabolize and respond to drugs similarly to adults. Institutional Review Boards/ethics committees should suspend ongoing questionable pediatric melanoma studies and reject newly submitted questionable studies.


Contouring variations and the role of atlas in non-small cell lung cancer radiation therapy: Analysis of a multi-institutional preclinical trial planning study.
To quantify variations in target and normal structure contouring and evaluate dosimetric impact of these variations in non-small cell lung cancer (NSCLC) cases. To study whether providing an atlas can reduce potential variation. Three NSCLC cases were distributed sequentially to multiple institutions for contouring and radiation therapy planning. No segmentation atlas was provided for the first 2 cases (Case 1 and Case 2). Contours were collected from submitted plans and consensus contour sets were generated. The volume variation among institution contours and the deviation of them from consensus contours were analyzed. The dose-volume histograms for individual institution plans were recalculated using consensus contours to quantify the dosimetric changes. An atlas containing targets and critical structures was constructed and was made available when the third case (Case 3) was distributed for planning. The contouring variability in the submitted plans of Case 3 was compared with that in first 2 cases. Planning target volume (PTV) showed large variation among institutions. The PTV coverage in institutions' plans decreased dramatically when reevaluated using the consensus PTV contour. The PTV contouring consistency did not show improvement with atlas use in Case 3. For normal structures, lung contours presented very good agreement, while the brachial plexus showed the largest variation. The consistency of esophagus and heart contouring improved significantly (t test; P < .05) in Case 3. Major factors contributing to the contouring variation were identified through a survey questionnaire. The amount of contouring variations in NSCLC cases was presented. Its impact on dosimetric parameters can be significant. The segmentation atlas improved the contour agreement for esophagus and heart, but not for the PTV in this study. Quality assurance of contouring is essential for a successful multi-institutional clinical trial.


Treacher Collins syndrome: A novel TCOF1 mutation and monopodial stapes.
Treacher Collins syndrome (TCS: OMIM 154500) is an autosomal dominant craniofacial disorder belonging to the heterogeneous group of mandibulofacial dysostoses. To investigate four Treacher Collins syndrome patients of the Sgaw Karen family living in Thailand. Clinical examination, hearing tests, lateral cephalometric analyses, Computed tomography, whole exome sequencing and Sanger direct sequencing were performed. All of the patients affected with Treacher Collins syndrome carried a novel TCOF1 mutation (c.4138_4142del; p.Lys1380GlufsTer12), but clinically they did not have the typical facial gestalt of Treacher Collins syndrome, which includes downward-slanting palpebral fissures, colobomas of the lower eyelids, absence of eyelashes medial to the colobomas, malformed pinnae, hypoplastic zygomatic bones and mandibular hypoplasia. Lateral cephalometric analyses identified short anterior and posterior cranial bases, and hypoplastic maxilla and mandible. Computed tomography showed fusion of malleus and incus, sclerotic mastoid, hypoplastic middle ear space with a soft tissue remnant, dehiscence of facial nerve and monopodial stapes. Treacher Collins syndrome in Sgaw Karen patients has not been previously documented. This is the first report of monopodial stapes in a TCS patient who had a TCOF1 mutation. The absence of a common facial phenotype and/or the presence of monopodial stapes may be the effects of this novel TCOF1 mutation.


Aerosol administration increases the efficacy of oseltamivir for the treatment of mice infected with influenza viruses.
Oseltamivir is an influenza neuraminidase inhibitor that along with supportive therapy has shown to help critically ill patients infected with H7N9 and H1N1pdm influenza virus strains to recover from disease. The standard of care recommends the administration of oseltamivir via oral route which represents difficulties in patients with gastrointestinal complications. Here we tested the use of aerosol administration of oseltamivir to treat mice infected with influenza A/H7N9 virus or influenza A/H1N1pdm virus and directly compared this approach to the standard of care, oral administration. Using nose only delivery of aerosolized oseltamivir we observed a significant increase in efficacy of the treatment compared to oral administration characterized by reduced body weight loss, increased survival rate and dose sparing. The preclinical data presented here supports the possibility of using this approach in clinical settings.


Human genetic history on the Tibetan Plateau in the past 5100 years.
Using genome-wide data of 89 ancient individuals dated to 5100 to 100 years before the present (B.P.) from 29 sites across the Tibetan Plateau, we found plateau-specific ancestry across plateau populations, with substantial genetic structure indicating high differentiation before 2500 B.P. Northeastern plateau populations rapidly showed admixture associated with millet farmers by 4700 B.P. in the Gonghe Basin. High genetic similarity on the southern and southwestern plateau showed population expansion along the Yarlung Tsangpo River since 3400 years ago. Central and southeastern plateau populations revealed extensive genetic admixture within the plateau historically, with substantial ancestry related to that found in southern and southwestern plateau populations. Over the past ~700 years, substantial gene flow from lowland East Asia further shaped the genetic landscape of present-day plateau populations. The high-altitude adaptive EPAS1 allele was found in plateau populations as early as in a 5100-year-old individual and showed a sharp increase over the past 2800 years.


Bone augmentation as an adjunct to dental implant rehabilitation in patients with diabetes mellitus: A review of literature.
The aim of the present article is to review the success of bone augmentation performed as an adjunct to dental implant rehabilitation in patients with diabetes mellitus. A literature review was conducted in PubMed on this topic, which yielded a total of 102 publications. For inclusion, publications had to be human studies, written in English language and should report on the success of bone augmentation as an adjunct to dental implant rehabilitation in diabetic patients. After screening the titles and abstracts, 11 full texts publications were obtained, of which seven were included in the review. These studies provided data on various bone augmentation techniques such as sinus floor elevation (SFE), guided bone regeneration (GBR), and onlay bone grafting. Even though the current review revealed that there are not many studies reporting data relevant to the analyzed topic, the data obtained suggests that; (1) staged GBR technique should be considered more feasible and predictable for bone augmentation, (2) clinicians must take meticulous care when planning and conducting SFE, and (3) block bone augmentation technique should be avoided.


Constraints for genetic association studies imposed by attributable fraction and familial risk.
Candidate gene studies have become very popular but some of their implicit constraints, such as the familial risk and the population attributable fraction (PAF) conferred by the gene under study, are poorly understood. We model here these parameters for susceptibility genes in terms of genotype relative risk (GRR), allele frequency and statistical power in simulated genetic association studies, assuming 500 or 2000 case-control pairs and different modes of inheritance. The results show that the common association studies on genes with minor allele frequency >10% have sufficient power to detect disease-causing variants conferring PAFs >10%, which can be compared to known genes, such as BRCA1 with a PAF of 1.8%. Yet, common low-risk variants confer low familial relative risks (FRRs), typically <1.1. The models show that candidate gene studies may be able to identify genes conferring close to 100% of the PAF, but they may not explain the empirical FRRs. In order to explain FRRs, rare, high-penetrant genes or interacting combinations of common variants need to be uncovered. However, the candidate gene studies for common alleles do not target this class of genes. The results may challenge the common disease-common variant hypothesis, which posits common variants with low GRRs and large PAFs, however failing to accommodate the empirical FRRs.


Modulation of upper limb joint work and power during sculling while ballasted with varying loads.
The human musculoskeletal system must modulate work and power output in response to substantial alterations in mechanical demands associated with different tasks. In particular, in water, upper limb muscles must perform net positive work to replace the energy lost against the dissipative fluid load. Where in the upper limb are work and power developed? Is mechanical output modulated similarly at all joints, or are certain muscle groups favored? This study examined, for the first time, how work and power per stroke are distributed at the upper limb joints in seven male participants sculling while ballasted with 4, 6, 8, 10 and 12 kg. Upper limb kinematics was captured and used to animate body virtual geometry. Net wrist, elbow and shoulder joint work and power were subsequently computed through a novel approach integrating unsteady numerical fluid flow simulations and inverse dynamics modeling. Across a threefold increase in load, total work and power significantly increased from 0.38±0.09 to 0.67±0.13 J kg-1, and 0.47±0.06 to 1.14±0.16 W kg-1, respectively. Shoulder and elbow equally supplied >97% of the upper limb total work and power, coherent with the proximo-distal gradient of work performance in the limbs of terrestrial animals. Individual joint relative contributions remained constant, as observed on land during tasks necessitating no net work. The apportionment of higher work and power simultaneously at all joints in water suggests a general motor strategy of power modulation consistent across physical environments, limbs and tasks, regardless of whether or not they demand positive net work.


Effects of insulin and adrenalectomy on elevation of serum leptin levels induced by 5-hydroxytryptophan in mice.
We previously reported that a serotonin precursor 5-hydroxytryptophan (5-HTP) increases serum leptin levels in mice. In this study, we studied the effects of insulin and adrenalectomy on hyperleptinemia induced by 5-HTP. Co-administration of insulin significantly increased hyperleptinemia elicited by 5-HTP. 5-HTP itself increased serum insulin levels. Adrenalectomy, which depletes corticosterone, did not abolish hyperleptinemic effects of 5-HTP. These results suggest that insulin may participate in hyperleptinemic effects of 5-HTP and that the involvement of corticosterone in effects of 5-HTP may be probably small.


Practical strategies for providing culturally sensitive, ethical care in developing nations.
Providing health care in developing nations results in cultural and ethical challenges for health care professionals. The authors' intent is to raise readers' awareness of how to maintain an ethical and culturally sensitive approach to practice in developing nations. Four practical approaches to ethical decision-making, developed from the literature and praxis, in conjunction with traditional moral theory and guidelines from professional and international organizations are discussed. Ethical multiculturalism, a view that combines universalism and multiculturalism undergirds culturally appropriate and ethically responsive decisions.


[Evolutionary approach to the understanding of structural and functional organization of Golgi apparatus].
This article analyzes the literature data related to the discussion of the main models of intracellular protein transport, including vesicular and cistern maturation-progression models. The existence of an important Golgi complex (GC) component--continuous tubular structures--is emphasized and their possible participation in the intracellular transport is discussed. A brief review is presented, describing the peculiarities of intracellular traffic in eukaryotic species belonging to different stages along the evolutionary process. The evidence suggests that in higher eukaryotes, the dynamic membranous GC system was formed on the basis of tubular networks that performs protein sorting and selective protein transport.


The Healing Effect of Conditioned Media and Bone Marrow-Derived Stem Cells in Laryngotracheal Stenosis: A Comparison in Experimental Dog Model.
Differences in causes, severities, areas of stenosis, and the association with swallowing and phonation of larynx and trachea can result into Laryngotracheal stenosis (LTS).This study evaluated the healing effect of bone marrow stem cells (BMSCs) in experimentally induced LTS dog model. Seven dogs were enrolled. BMSCs were isolated from proximal humerus and shoulder of a dog and cultured in media containing alpha minimal essential medium, fetal bovine serum, penicillin and streptomycin, and L-glutamine. BMSCs were characterized morphologically, by RT-PCR, and osteogenic induction. Karyotyping was undertaken for chromosomal stability. Mechanical trauma to laryngeal mucosa was identically conducted by Tru-cut punch forceps in right and left vocal folds. Two milliliter of conditioned media or BMSCs (2×106) were injected in the right site of the tissue and the left side was considered as control after LTS induction. The larynx was visualized 2, 4 and 6 weeks after treatment. Six weeks post-treatment, the larynges were evaluated histologically. BMSCs were adhered to culture flasks, spindle shape and positive for mesenchymal marker and negative for hematopoietic markers. Osteogenic induction was verified by Alizarin red staining. Karyotype was normal. A complete epithelialization and minimal chronic inflammatory cell infiltration were noted in submucosa of both left (control) and right (cases) vocal folds. The healing effect of conditioned media and BMSCs in comparison to the control group was more prominent. As thickness of fibrosis in cases were less than control group, conditioned media and BMSCs were shown to be good choices in healing of LTS.


{μ-6,6'-Dimeth-oxy-2,2'-[propane-1,3-diylbis(nitrilo-methanylyl-idene)]di-phenolato}dimethano-ltrinitrato-samarium(III)zinc(II) methanol disolvate.
In the title complex, [SmZn(C(19)H(20)N(2)O(4))(NO(3))(3)(CH(3)OH)(2)]·2CH(3)OH, the Zn(II) ion is six-coordinated by two O atoms and two N atoms of the deprotonated Schiff base ligand and by two O atoms from methanol mol-ecules, forming a slightly distorted octa-hedral geometry. The Sm(III) ion is coordinated by six O atoms from three chelating nitrate ligands and four O atoms from the Schiff base ligand, forming a distorted bicapped square-anti-prismatic environment. In the crystal, inter-molecular O-H⋯O hydrogen bonds connect the complex mol-ecules and the two methanol solvent mol-ecules, forming (10[Formula: see text]) sheets.


New tricks of well-known aminoazoles in isocyanide-based multicomponent reactions and antibacterial activity of the compounds synthesized.
The well-known aminoazoles, 3-amino-5-methylisoxazole and 5-amino-N-aryl-1H-pyrazole-4-carboxamides, were studied as an amine component in Ugi and Groebke-Blackburn-Bienaymé multicomponent reactions. The first example of an application of aminoazoles in an Ugi four-component reaction was discovered and novel features of a Groebke-Blackburn-Bienaymé cyclocondensation are established and discussed. The heterocycles obtained were evaluated for their antibacterial activity and several of them demonstrated a weak antimicrobial effect, but for most of the compounds a 30-50% increase in biomass of Gram-positive strains (mainly B. subtilis) compared to control was observed.


Supramolecular porphyrin assemblies through amidinium-carboxylate salt bridges and fast intra-ensemble excited energy transfer.
Well-defined supramolecular assemblies of Zn and free-base porphyrins are constructed through the formation of amidinium-carboxylate salt bridges. A one-to-one donor-acceptor pair and a four-to-one antenna-type assembly are investigated. The steady-state and time-resolved fluorescence measurements unequivocally showed that efficient singlet-singlet excited energy transfer from the Zn-porphyrin complex to the free-base porphyrin takes place in these assemblies. Indeed, the observed energy-transfer rates in both types of assemblies are much faster than those the Förster mechanism would suggest, implying the involvement of an intermolecular through-bond mechanism.


[Appendiceal mucocele. Apropos of 6 cases].
Appendicular mucocele is a rare lesion presenting a combination of several histological lesions. It generally ruptures into the peritoneum and rarely into the retroperitoneum. The objective of this study was to examine the various radiological appearances of appendicular mucocele and to report three cases of mucocele which ruptured into the retroperitoneum. This retrospective series of 6 cases of histologically confirmed appendicular mucocele was collected by the Central Radiology Department of Ibn Rochd University Hospital in Casablanca. The mean age of the patients was 61.6 years (33 years-77 years) and the sex ratio was 4/2. A plain abdominal X-ray and ultrasonography were performed in all patients. Five patients were examined by CT scan and two underwent a barium enema. Five out of six mucoceles ruptured: into the peritoneal cavity in 2 cases with gelatinous ascites and into the retroperitoneum in 3 cases. The plain abdominal X-ray showed a mass in the right flank, which was calcified in 2 cases. Ultrasonography and CT scan were suggestive of the diagnosis of appendicular mucocele in only two cases. The case of non ruptured mucocele consisted of a clearly delimited, thin-walled collection. A loculated effusion with scalloping on the liver was observed in the two cases of gelatinous ascites. In the three cases of mucocele rupturing into the retroperitoneum, ultrasonography and CT scan showed a loculated retroperitoneal collection. This collection extended into the right psoas in 2 out of 3 cases. Gelatinous ascites is the usual complication of appendicular mucocele; but in rare cases of mucocele of a retrocaecal appendix, the mucus may enter the retroperitoneum.


Factors associated with Echinococcus multilocularis infection in coyotes in southern Ontario.
Echinococcus multilocularis was recently reported in wild canids across southern Ontario, a newly recognized endemic area in Canada. In such areas, a comprehensive understanding of factors associated with infection in definitive hosts (wild canids) is critical for mitigating risk of transmission to humans. However, little is known about the transmission dynamics of the parasite in definitive hosts for this region. A study was therefore carried out to investigate the association of host-level (sex, body condition), environmental (southern Ontario region, land cover), temporal (season, hunting season, calendar year) and extraneous factors (submitter type) with E. multilocularis infection in coyotes in southern Ontario. Between November 2015 and March 2017, 416 coyotes were collected from across the region as part of a study that investigated the prevalence and distribution of the parasite in wild canids; approximately 24% of coyotes were positive for E. multilocularis. Associations between infection and factors of interest were assessed via a mixed-effects logistic regression model with a random intercept for submitter to account for clustering. Coyotes with poor body condition were at greater odds of E. multilocularis infection than those in good condition (odds ratio [OR] 2.14; 95% CI: 1.08-4.26; p = .030). A negative association was observed between infection in coyotes and the proportion of natural land in a coyote's estimated home range (OR: 0.67; 95% CI: 0.52-0.85; p = .001). Coyotes from the western region of southern Ontario had lower odds of infection compared to coyotes from the central region (OR: 0.26; 95% CI: 0.12-0.55; p < .001). These results can be used to help guide future public health prevention strategies for human alveolar echinococcosis.


A Review on Antihyperglycemic and Antihepatoprotective Activity of Eco-Friendly Punica granatum Peel Waste.
Over the past decade, pomegranate (Punica granatum) is entitled as a wonder fruit because of its voluminous pharmacological properties. In 1830, P. granatum fruit was first recognized in United States Pharmacopeia; the Philadelphia edition introduced the rind of the fruit, the New York edition the bark of the root and further 1890 edition the stem bark was introduced. There are significant efforts and progress made in establishing the pharmacological mechanisms of peel (pericarp or rind) and the individual constituents responsible for them. This review provides an insight on the phytochemical components that contribute too antihyperglycemic, hepatoprotective, antihyperlipidemic effect, and numerous other effects of wonderful, economic, and eco-friendly pomegranate peel extract (PP).


Pulmonary artery sarcoma masquerading as chronic pulmonary thromboembolism.
We describe the case of a 60-year-old woman who presented with pulmonary artery sarcoma, a very rare tumor of the cardiovascular system. Her tumor was initially misdiagnosed as chronic pulmonary thromboembolism, and she underwent pulmonary endarterectomy. Early diagnosis of primary pulmonary artery sarcoma is crucial. That alternative should always be considered before settling on a diagnosis of pulmonary embolism. Suspicion should be aroused by the failure of anticoagulant treatment to alleviate pulmonary perfusion abnormalities and systemic symptoms. Surgical resection of the tumor-preferably by pulmonary endarterectomy, followed by reconstruction as needed-is currently the most promising treatment for pulmonary artery sarcoma.


[Clinical case of the month. Iliac artery endofibrosis in a soccer player].
Arterial endofibrosis is a rare disease, usually affecting the external iliac artery in highly trained athletes. We report a case of external iliac endofibrosis in 42-year-old top level athlete. Clinical consequences were a high intensity exercise related sensation of swollen thigh, with normal clinical examination. Ultra sound investigation showed fibrotic thickening of the left external iliac artery. Angiography confirmed stenosis of the left external iliac artery. The patient was treated surgically, he underwent remodeling of his left external iliac artery with venous angioplasty. No complications occurred in the post operative course, and the patient return to training after three months.


Unwinding the role of Wnt signaling cascade and molecular triggers of motor neuron degeneration in amyotrophic lateral sclerosis (ALS).
Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative condition, triggered by various factors causing the degeneration of upper and lower motor neurons, resulting in progressive muscle wasting, paralysis, and death. Multiple in vivo and in vitro models have been established to unravel the molecular events leading to the deterioration of motor neurons in ALS. The canonical and non-canonical Wnt signaling pathway has been implicated to play a crucial role in the progression of neurodegenerative disorders. This review discusses the role of Wnt signaling in the reported causes of ALS such as oxidative stress, mitochondrial dysfunction, autophagy, and apoptosis. Mutations in ALS-associated genes such as SOD1, C9orf72, TDP43, FUS, and OPTN cause an imbalance in neuronal integrity and homeostasis leading to motor neuron demise. Wnt signaling is also observed to play a crucial role in the muscle sparing of oculomotor neurons. The non-canonical Wnt/Ca2+ pathway which regulates intrinsic electrophysiological properties and mobilizes calcium ions to maintain neuronal integrity has been found to be altered in the stem cell-derived ALS model. Thus, the interplay of dysregulated canonical and non-canonical Wnt pathways in multiple motor neuron disease models has shown that Wnt contributes to disease progression indicating it to be utilized as a potential target for ALS.


Bias, the unfinished symphony.
In laboratory medicine, mathematical equations are frequently used to calculate various parameters including bias, imprecision, measurement uncertainty, sigma metric (SM), creatinine clearance, LDL-cholesterol concentration, etc. Mathematical equations have strict limitations and cannot be used in all situations and are not open to manipulations. Recently, a paper "Bias estimation for Sigma metric calculation: Arithmetic mean versus quadratic mean" was published in Biochemia Medica. In the paper, the author criticized the approach of taking the arithmetic mean of the multiple biases to obtain a single bias and proposed a quadratic method to estimate the overall bias using external quality assurance services (EQAS) data for SM calculation. This approach does not fit the purpose and it should be noted that using the correct equation in calculations is as important as using the correct reagent in the measurement of the analytes, therefore before using an equation, its suitability should be checked and confirmed.


Relationship between serum concentrations of saturated fatty acids and unsaturated fatty acids and the homeostasis model insulin resistance index in Japanese patients with type 2 diabetes mellitus.
Consumption of polyunsaturated fatty acids (PUFA) improves the lipid metabolism of diabetics, leading to prevents of arteriosclerosis. Exact relationship between saturated fatty acids (SFA) or PUFA and the insulin resistance of diabetics are unknown. We investigated the relationship between the serum concentrations of saturated and unsaturated fatty acids and the homeostasis model insulin resistance index (HOMA-R) in Japanese patients with type 2 diabetes mellitus. The SFA, i.e., lauric acid, myristic acid, palmitic acid, and stearic acid; the monounsaturated fatty acids (MUFA), i.e., palmitoleic acid, oleic acid, and erucic acid; and the PUFA, i.e., eicosadienoic acid, dihomo-gamma-linolenic acid, docosatetraenoic acid, and docosapentaenoic acid were positively correlated with HOMA-R. However, no correlations were found between HOMA-R and SFA, i.e., arachidic acid, behenic acid, and lignoceric acid; the MUFA, i.e., eicosenoic acid and nervonic acid; and the PUFA, i.e., linoleic acid, gamma-linolenic acid, linolenic acid, 5-8-11 eicosatrienoic acid, arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid. Some PUFA as well as SFA were positively correlated with HOMA-R. These results indicate that the intake of diet fatty acid must be well balanced in diabetic patients and it is not always true to refrain from taking SFA and increase the unsaturated fatty acids in their diets.


Histological and transcriptomic effects of 17α-methyltestosterone on zebrafish gonad development.
Sex hormones play important roles in teleost ovarian and testicular development. In zebrafish, ovarian differentiation appears to be dictated by an oocyte-derived signal via Cyp19a1a aromatase-mediated estrogen production. Androgens and aromatase inhibitors can induce female-to-male sex reversal, however, the mechanisms underlying gonadal masculinisation are poorly understood. We used histological analyses together with RNA sequencing to characterise zebrafish gonadal transcriptomes and investigate the effects of 17α-methyltestosterone on gonadal differentiation. At a morphological level, 17α-methyltestosterone (MT) masculinised gonads and accelerated spermatogenesis, and these changes were paralleled in masculinisation and de-feminisation of gonadal transcriptomes. MT treatment upregulated expression of genes involved in male sex determination and differentiation (amh, dmrt1, gsdf and wt1a) and those involved in 11-oxygenated androgen production (cyp11c1 and hsd11b2). It also repressed expression of ovarian development and folliculogenesis genes (bmp15, gdf9, figla, zp2.1 and zp3b). Furthermore, MT treatment altered epigenetic modification of histones in zebrafish gonads. Contrary to expectations, higher levels of cyp19a1a or foxl2 expression in control ovaries compared to MT-treated testes and control testes were not statistically significant during early gonad development (40 dpf). Our study suggests that both androgen production and aromatase inhibition are important for androgen-induced gonadal masculinisation and natural testicular differentiation in zebrafish.


Cell and Protein Recognition at a Supported Bilayer Interface via In Situ Cavitand-Mediated Functional Polymer Growth.
Water-soluble deep cavitands embedded in a supported lipid bilayer are capable of anchoring ATRP initiator molecules for the in situ synthesis of primary amine-containing polymethacrylate patches at the water:membrane interface. These polymers can be derivatized in situ to incorporate fluorescent reporters, allow selective protein recognition, and can be applied to the immobilization of nonadherent cells at the bilayer interface.


Polycythemia vera presenting with bilateral papilledema: a rare case report.
A 45-year-old male patient presented with gradual onset of headache, vomiting and blurring of vision of 28 days duration. Ophthalmological examination revealed normal anterior segment and pupillary reflex. No abnormality was detected in the vitreous. Optic disc showed features of advanced papilledema with normal macula and retinal periphery in both eyes. Visual acuity was 20/200 in the right eye and counting fingers close range in the left eye. Non-contrast computed tomography of brain was normal and magnetic resonance imaging showed sagittal sinus thrombosis without any evidence of venous infarction or intracranial mass. Routine hematological investigations revealed increased hemoglobin level, packed cell volume and leucocytosis. Further investigation revealed increased Vitamin B12 and decreased serum erythropoietin. A diagnosis of polycythemia vera was made from the above findings. This case is being presented for the rarity of association of polycythemia vera with bilateral advanced papilledema due to sagittal sinus thrombosis.


The subiculum: a potential site of action for novel antipsychotic drugs?
In this article, recent information from neuropathological studies in humans and behavioural and electrophysiological/pharmacological studies in rats is used to examine the hypothesis that the subiculum, the major output region of the hippocampal formation, may contain sites of action for novel antipsychotic drugs. In the first section, the possible interactions between subicular neurons and the sites at which existing antipsychotic drugs act are discussed. These include the interaction implied by convergence of subicular and dopaminergic inputs to the nucleus accumbens. The second section concentrates upon subicular involvement in animal behaviours that are thought to be relevant to schizophrenia, which, in rats, include Latent inhibition and Pre-pulse inhibition of Acoustic Startle. Involvement of the subiculum in the neuropathology of schizophrenia is discussed in the third section. However, few neuropathological studies comment specifically on the subiculum. Those which suggest involvement tend to be recent and, as yet, have not all been replicated. Finally, there is discussion of the possibility that the subiculum contains chemical sites at which drugs could act specifically to produce appropriate physiological effects. Potential sites include, but are not necessarily restricted to, particular ion channels in electrophysiologically defined subclasses of subicular pyramidal neurons, the receptors for neuromodulatory peptides such as somatostatin and cholecystokinin, and the enzyme nitric oxide synthase. It is concluded that a wide range of clinical and basic neuroscience disciplines has provided evidence which, especially when viewed as a whole, is consistent with the hypothesis that the subiculum is a potential site of action for novel antipsychotic drugs.


Quantification and assessment of detection capability in imaging mass spectrometry using a revised mimetic tissue model.
Aim: A revised method of preparing the mimetic tissue model for quantitative imaging mass spectrometry (IMS) is evaluated. Concepts of assessing detection capability are adapted from other imaging or mass spectrometry (MS)-based technologies to improve upon the reliability of IMS quantification. Materials & methods: The mimetic tissue model is prepared by serially freezing spiked-tissue homogenates into a cylindrical mold to create a plug of tissue with a stepped concentration gradient of matrix-matched standards. Weighted least squares (WLS) linear regression is applied due to the heteroscedastisity (change in variance with intensity) of most MS data. Results & conclusions: Imaging poses several caveats for quantification which are unique compared with other MS-based methods. Aspects of the design, construction, application, and evaluation of the matrix-matched standard curve for the mimetic tissue model are discussed. In addition, the criticality of the ion distribution in the design of a purposeful liquid chromatography coupled to mass spectrometry (LC-MS) validation is reviewed.


Emodin protects against lipopolysaccharide-induced inflammatory injury in HaCaT cells through upregulation of miR-21.
Background/aim: Pressure ulcers are a disastrous health issue in which inflammation is involved. Emodin possesses biological properties in inflammation. Our study investigated functions of emodin in lipopolysaccharide (LPS)-treated HaCaT cells. Methods: LPS was used to induce cell inflammation. MTT and flow cytometry were applied for cell viability and apoptosis assays, respectively. Moreover, apoptotic proteins were detected by western blot. Similarly, inflammatory factors and signalling related proteins were also determined by western blot. Results: Emodin increased cell viability and diminished apoptosis in LPS-treated HaCaT cells. Moreover, cleaved-PARP, cleaved-caspase-3 and cleaved-caspase-9 were all downregulated by emodin. Furthermore, inflammatory factors IL-1β, IL-6, Cox-2 and iNOS were inhibited by emodin in LPS-treated cells. In addition, emodin decreased phosphorylation of p65 and IκBα and the level of PTEN while enhanced phosphorylation of PI3K and AKT. Importantly, emodin increased expression of miR-21 suppressed by LPS and miR-21 downregulation negated the protective functions of emodin. Conclusions: Emodin promoted cell growth presented by increasing viability and blocking apoptosis process with inflammation inhibition. The protective activity of emodin was mediated by miR-21 up-regulation.


Scramblases and virus infection.
The asymmetric distribution of lipids, maintained by flippases/floppases and scramblases, plays a pivotal role in various physiologic processes. Scramblases are proteins that move phospholipids between the leaflets of the lipid bilayer of the cellular membrane in an energy-independent manner. Recent studies have indicated that viral infection is closely related to cellular lipid distribution. The level and distribution of phosphatidylserine (PtdSer) in cells have been demonstrated to be critical regulators of viral infections. Previous studies have supported that the infection of human immunodeficiency virus (HIV), Zika virus, Ebola virus (EBOV), influenza virus, and dengue fever virus require the externalization of phospholipids mediated by scramblases, which are also involved in the pathogenicity of the pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this review, we review the relationship of scramblases with viruses and the potential viral effector proteins that might utilize host scramblases.


[Metabolism of guanine in the adenohypophysis of the male rat during growth and after castration].
During incubation of the male Rat pituitary, guanine is metabolized according to two ways: the first one leads to the guanylic nucleotides subsequently incorporated into the RNA; the second one produces xanthine and uric acid. If guanosine is used as a precursor, the nucleoside is converted into guanine before utilisation thus suggesting a low level of guanosine kinase activity. The production of xanthine is higher in adult animals than in immature ones and it is increased following gonadectomy. It follows that the pituitary guanine deaminase could be considered as an enzyme regulated by sexual hormones.


Thyroid suppression test with a single oral dose of levothyroxine in the diagnosis of functional thyroid autonomy.
To propose a modified form of thyroid suppression test with use of a single oral dose of levothyroxine (35 mg/kg). After a baseline scintigram, 23 patients with nodular goiter suspected of autonomous function (warm or hot nodules, subnormal or undetectable thyrotropin levels, or both findings) and 14 normal subjects underwent a repeated scintigram 4 days after administration of levothyroxine. We evaluated triiodothyronine (T(3)), free thyroxine, and thyrotropin before and on the first, second, third, fourth, and seventh days after administration of the individualized dose of levothyroxine. The 99th percentile of postsuppression uptake in normal subjects was determined, and an uptake >12.4%, a 131 I concentration restricted to the nodule, or both factors were adopted as the criteria for diagnosis of an autonomously functioning thyroid nodule. Twelve patients were considered to have autonomously functioning nodules, and 11 patients were considered to have nonautonomous nodules. Baseline thyrotropin levels in patients with autonomous nodules did not differ significantly from those in patients with nonautonomous nodules. No signs or symptoms of toxicity were detected during the test, but all study subjects had increased free thyroxine values, and seven had high levels of T(3). The thyroid suppression test with 35 mg/kg of levothyroxine is an effective method for the diagnosis of an autonomously functioning thyroid nodule, is nontoxic, and avoids the inaccurate use of the medication occasionally observed with T(3). Even sensitive methods of thyrotropin determination cannot replace this test in the evaluation of autonomous thyroid function.


A chemical treatment regimen to reduce bacterial contamination in dental waterlines.
This article describes a pilot study in which the authors used aerobic bacterial cultures to compare the effects of 1:10 mouthwash, 1:20 mouthwash and 2 percent ethanol in reservoir systems with seven conventional water systems. The long-term, low-concentration antiseptic reduced bacteria to within acceptable limits.


Traumatic thoracic fistulas.
This article considers the wide range of fistulas that can result from blunt and penetrating trauma. The mechanisms, physical signs, diagnostic techniques, and nonoperative and operative management strategies for fistulas of the thorax are reviewed. Emphasis is placed on the requirement for a high index of suspicion in specific types of injury in which thoracic fistulas can occur.


The mechanism of acute elbow flexion contracture in children with congenital proximal radioulnar synostosis.
We have evaluated and treated 3 cases of acute onset elbow flexion contracture in children ranging in age from 6 to 13 years, with type-IV (Cleary and Omer) congenital proximal radioulnar synostosis. All were resolved by manipulative traction under general anesthesia during which an audible elbow "snap" was noted. Two of the cases required surgical treatment of a deformed radial head with good results after a 2 to 4-year follow-up. Our clinical radiographic and intraoperative evidence suggests that the acute onset fixed-flexion contracture results from an anterosuperiorly overgrown dislocated radial head becoming trapped under hypertrophied annular ligament-type tissue after elbow hyperflexion. Excision of the dislocated radial head after release from its entrapment was effective in 2 of the 3 patients in this report, and should be considered.


[Characteristics of high-risk cardiovascular disease among residents aged 35-75 in 8 districts of Beijing].
Objective: To understand the characteristics and current situation of high risks related to cardiovascular disease among residents aged 35-75 in Beijing and to provide scientific reference for the formulation and improvement of cardiovascular disease prevention and control strategies and measures. Methods: According to the data of the Cardiovascular Disease Screening and Management Program in Beijing, 93 520 participants aged 35-75 in 8 districts of Beijing were selected for analysis. We used the χ2 test to compare the high-risk prevalence of cardiovascular disease in different population characteristics. The multivariate logistic regression model was used to analyze the relationship between population characteristics and the high risks of cardiovascular disease. Results: The prevalence of high-risk cardiovascular disease was 20.82% (19 471/93 520). The prevalence of high-risk population in the 65-75 years-old was significantly higher than those of other age groups [29.05% (5 151/17 733), χ2=3 359.37, P<0.001], and the prevalence increased with age (trend χ2=3 121.75, P<0.05). The prevalence of high risk in males was significantly higher than that of women (31.19%, 10 752/34 476 vs. 14.77%, 8 719/59 044, χ2=3 559.87, P<0.05). The most common clustered risk factors appeared as hypertension and diabetes (29.80%, 5 802/19 471), hypertension with smoking (37.84%, 4 069/10 752) in males, and hypertension with diabetes mellitus in females (49.32%, 4 300/8 719), in urban areas (33.62%, 2 571/7 647) and in suburbs (27.33%, 3 231/11 824). Lower education [high school (OR=1.56,95%CI:1.46-1.66), middle school (OR=1.99,95%CI:1.88-2.12), primary school and below (OR=2.28,95%CI:2.12-2.45)], non-Han ethnicity (OR=1.19, 95%CI: 1.07-1.33), unmarried (OR=1.16, 95%CI: 1.08-1.24), drinking alcohol (OR=3.06, 95%CI: 2.94-3.19), obesity (OR=1.85, 95%CI: 1.77-1.93), overweight (OR=1.41, 95%CI: 1.36-1.47), etc., were positively correlated with the high risk of cardiovascular disease. Conclusions: We noticed that the prevalence of high-risk groups of cardiovascular disease aged 35-75 years was around 20% in Beijing, and the proportion in males was higher than females. Low education, drinking, overweight, and obesity were positively correlated with the risks of cardiovascular disease.


Subtilisin inhibitors in legume seeds.
Subtilisin inhibitors (SI) having an average molecular mass of 8 kDa purified from jack beans (Canavalia ensiformis) and broad beans (Vicia faba) to electrophoretical homogeneity are compared to those isolated from chick peas (Cicer arietinum) and black beans (Phaseolus vulgaris). The specificity spectrum of SI is restricted to microbial serine proteinases. Their interaction with subtilisin Carlsberg is variable, obtaining the highest value for black bean, followed by broad bean, chick pea and jack bean inhibitors. Proteinase K reacts with most SI twice as strongly as subtilisin. The reaction of SI with subtilisin apparently follows the "standard mechanism" proposed by Laskowski for the interaction of trypsin with its inhibitors. Accordingly, the reactive site of jack bean, broad bean and black bean SI is reversibly cleaved by subtilisin in acid and neutral solutions, whereas chick pea SI is hydrolysed only at neutral pH values. Judged by similarities in specificity, molecular mass, heat stability and reactive site cleavage, the SI from legume seeds could constitute a new "family" of proteinase inhibitors.


FOXOs attenuate bone formation by suppressing Wnt signaling.
Wnt/β-catenin/TCF signaling stimulates bone formation and suppresses adipogenesis. The hallmarks of skeletal involution with age, on the other hand, are decreased bone formation and increased bone marrow adiposity. These changes are associated with increased oxidative stress and decreased growth factor production, which activate members of the FOXO family of transcription factors. FOXOs in turn attenuate Wnt/β-catenin signaling by diverting β-catenin from TCF- to FOXO-mediated transcription. We show herein that mice lacking Foxo1, -3, and -4 in bipotential progenitors of osteoblast and adipocytes (expressing Osterix1) exhibited increased osteoblast number and high bone mass that was maintained in old age as well as decreased adiposity in the aged bone marrow. The increased bone mass in the Foxo-deficient mice was accounted for by increased proliferation of osteoprogenitor cells and bone formation resulting from upregulation of Wnt/β-catenin signaling and cyclin D1 expression, but not changes in redox balance. Consistent with this mechanism, β-catenin deletion in Foxo null cells abrogated both the increased cyclin D1 expression and proliferation. The elucidation of a restraining effect of FOXOs on Wnt signaling in bipotential progenitors suggests that FOXO activation by accumulation of age-associated cellular stressors may be a seminal pathogenetic mechanism in the development of involutional osteoporosis.


Galectin-1, an endogenous lectin produced by thymic epithelial cells, induces apoptosis of human thymocytes.
Galectin-1, a beta-galactoside binding protein, is produced by thymic epithelial cells and binds to human thymocytes. We have previously reported that galectin-1 induces the apoptosis of activated T lymphocytes. Because the majority of thymocytes die via apoptosis while still within the thymus, we tested whether galectin-1 could induce the apoptosis of these cells. We now report that in vitro exposure to galectin-1 induced apoptosis of two subsets of CD4(lo) CD8(lo) thymocytes. The phenotypes of susceptible thymocytes were consistent with that of both negatively selected and nonselected cells. Galectin-1-induced apoptosis was enhanced by preexposure of thymocytes to antibody to CD3, suggesting that galectin-1 may be a participant in T-cell- receptor mediated apoptosis. In contrast, pretreatment of thymocytes with dexamethasone had no effect on galectin-1 susceptibility. We noted that 71% of the cells undergoing apoptosis after galectin-1 treatment had a DNA content greater than 2N, indicating that proliferating thymocytes were most sensitive to galectin-1. We propose that galectin-1 plays a role in the apoptosis of both negatively selected and nonselected thymocytes, and that the susceptibility of thymocytes to galectin-1 is regulated, in part, by entry or exit from the cell cycle.


Influence of environment on speech-sound discrimination: findings from a longitudinal study.
Event-related potentials (ERPs) from 134 children were obtained at 3 and 8 years of age and recorded to a series of consonant-vowel speech syllables and their nonspeech analogues. The HOME inventory was administered to these same children at 3 and 8 years of age and the sample was divided into 2 groups (low vs. high) based on their HOME scores. Discriminant functions analyses using ERP responses to speech and non-speech analogues successfully classified HOME scores obtained at 3 and 8 years of age and discriminated between children who received low vs. high levels of stimulation for language and reading.


HLA-Bw60 increases susceptibility to ankylosing spondylitis in HLA-B27+ patients.
We examined the distribution of non-B27 alleles of the HLA-B locus among B27+ patients with ankylosing spondylitis (AS), to detect any additional HLA-B locus allele(s) that may act in conjunction with B27 to increase susceptibility to AS. HLA-Bw60 (or B40 when the Bw60,61 split of B40 was not typed for) was shown to be increased among B27+ AS patients in each of 5 independent data sets. This increase was statistically significant in 4 of the 5 data sets studied, and the overall significance was P less than 0.00001. Susceptibility to AS in B27+ individuals was further increased by a factor of approximately 3 when Bw60 was also present. The distribution of HLA-A alleles on the B27-bearing haplotypes in AS patients was not significantly different from that in normal controls. On the other hand, the distribution of HLA-A alleles on Bw60-bearing haplotypes was significantly different from the distribution of A alleles on Bw60 haplotypes in the general population (P less than 0.0005). Bw60 was not increased in B27- patients with AS. A dominant mode of inheritance generally fits AS; however, our sib pair analysis indicates that the B27,Bw60 disease subgroup follows a more recessive mode of inheritance.


Non-invasive in vivo imaging of calcium signaling in mice.
Rapid and transient elevations of Ca(2+) within cellular microdomains play a critical role in the regulation of many signal transduction pathways. Described here is a genetic approach for non-invasive detection of localized Ca(2+) concentration ([Ca(2+)]) rises in live animals using bioluminescence imaging (BLI). Transgenic mice conditionally expressing the Ca(2+)-sensitive bioluminescent reporter GFP-aequorin targeted to the mitochondrial matrix were studied in several experimental paradigms. Rapid [Ca(2+)] rises inside the mitochondrial matrix could be readily detected during single-twitch muscle contractions. Whole body patterns of [Ca(2+)] were monitored in freely moving mice and during epileptic seizures. Furthermore, variations in mitochondrial [Ca(2+)] correlated to behavioral components of the sleep/wake cycle were observed during prolonged whole body recordings of newborn mice. This non-invasive imaging technique opens new avenues for the analysis of Ca(2+) signaling whenever whole body information in freely moving animals is desired, in particular during behavioral and developmental studies.


The Relationship between Werner Syndrome and Sinonasal Malignant Melanoma: Two Sibling Cases of Werner Syndrome with Malignant Melanoma.
Werner syndrome (WS) is an autosomal recessive disease characterized by premature aging. Malignant tumors such as thyroid carcinoma and malignant melanoma occur frequently in WS patients. We describe 2 siblings with WS who suffered from sinonasal malignant melanoma (MM). Both patients initially experienced nasal obstruction and recurrent nasal bleeding and died within 2 years of the diagnosis of MM. Otolaryngologists should recognize that WS patients have a high risk for head and neck malignant disease, particularly sinonasal MM, even if they are aged below the expected age range and undergo periodic examinations. Furthermore, it is important that WS patients are aware that a prompt nasal examination is indicated if they experience continuous nasal obstruction or recurrent nasal bleeding.


Malignant melanoma of the gallbladder: A case report and literature review.
Metastatic melanoma of the gallbladder is extremely rare. It has a poor prognosis. Its optimal treatment remains unclear. Surgical resection is generally considered the mainstay of treatment. However, there are no standards to guide the choice between open surgery and laparoscopic surgery. Criteria for the extent of surgical dissection have not been established yet either. We report a patient diagnosed with gallbladder cancer who underwent extended cholecystectomy but had metastatic melanoma at the final biopsy. We reviewed the literature on the treatment of metastatic melanoma in the gallbladder and compared it with our case to determine a treatment strategy.


Pulsed-field gel electrophoresis typing of Hafnia alvei isolated from chub-packed and retail ground beef.
Thirty-eight isolates of Hafnia alvei were characterized by biochemical profiles, ribotyping and pulsed-field gel electrophoresis (PFGE) patterns. The isolates were recovered from chub-packed (19 isolates) or retail (nine isolates) ground beef, or were obtained from culture repositories (10 isolates). Biochemical profiling differentiated the 38 isolates into five groups and a commercial ribotyping method recognized 11 groups, whereas PFGE differentiated the same 38 isolates into 19 groups. These data substantiate that PFGE is a highly discriminatory tool for establishing the relatedness among Hafnia alvei strains.


Particle chains in a dilute dusty plasma with subsonic ion flow.
Chains of charged dust particles are observed aligned with a subsonic ion flow. These chains are found in dilute regions, near the midplane of a parallel-plate radio-frequency plasma under microgravity conditions. The argon ion flow speed near these chains was estimated to be of order 10(2) m/s, corresponding to an ion acoustic Mach number M<0.1. The chains were observed to be stable in both the longitudinal and transverse directions. This stability suggests that there is a transverse restoring force. The transverse components of the ion-drag force or electrostatic wake-field forces could provide such a stabilizing effect. The chain appears to terminate with a final dust particle that is located in a dilute region; this observation suggests a possible attractive force in the longitudinal direction in the presence of a subsonic ion flow.


Prediction of marker genes associated with hypertension by bioinformatics analyses.
This study aimed to explore the underlying marker genes associated with hypertension by bioinformatics analyses. A gene expression profile (GSE54015) was downloaded. The differentially expressed genes (DEGs) between the normotensive female (NF) and hypertensive female (HF), and between the normotensive male (NM) and hypertensive male (HM) groups were analyzed. Gene Ontology (GO) and pathway enrichment analyses were performed, followed by protein-protein interaction (PPI) network construction. The transcription factors (TFs), and the common DEGs between the HF and HM groups were then analyzed. In total, 411 DEGs were identified between the HF and NF groups, and 418 DEGs were identified between the HM and NM groups. The upregulated DEGs in the HF and HM groups were enriched in 9 GO terms, including oxidation reduction, such as cytochrome P450, family 4, subfamily b, polypeptide 1 (Cyp4b1) and cytochrome P450, family 4, subfamily a, polypeptide 31 Cyp4a31). The downregulated DEGs were mainly enriched in GO terms related to hormone metabolic processes. In the PPI network, cytochrome P450, family 2, subfamily e, polypeptide 1 (Cyp2e1) had the highest degree in all 3 analysis methods in the HF group. Additionally, 4 TFs were indentified from the 2 groups of data, including sterol regulatory element binding transcription factor 1 (Srebf1), estrogen receptor 1 (Esr1), retinoid X receptor gamma (Rxrg) and peroxisome proliferator-activated receptor gamma (Pparg). The intersection genes were mainly enriched in GO terms related to the extracellular region. On the whole, our data indicate that the DEGs, Cyp4b1, Cyp4a31 and Loxl2, and the TFs, Esr1, Pparg and Rxrg, are associated with the progression of hypertension, and may thus serve as potential therapeutic targets in this disease.


Genotype × prenatal and post-weaning nutritional environment interaction in a composite beef cattle breed using reaction norms and a multi-trait model.
Environmental effects have been shown to influence several economically important traits in beef cattle. In this study, genotype × nutritional environment interaction has been evaluated in a composite beef cattle breed (50% Red Angus, 25% Charolais, 25% Tarentaise). Four nutritional environments (marginal-restricted [MARG-RES], marginal-control [MARG-CTRL], adequate-restricted [ADEQ-RES], and adequate-control [ADEQ-CTRL]) were created based on two levels of winter supplement provided to dams grazing winter range during gestation (MARG and ADEQ) and two levels of input to offspring during post-weaning development (RES and CTRL). Genetic parameters of average daily gain (ADG) during the 140-d post-wean trial, yearling weight (YW), and ultrasound measurement of fat depth (FAT) at the 12th rib and intramuscular fat percentage (IMF) of 3,020 individuals in the four environments were estimated. The heritabilities estimated using a single trait mixed linear model were: ADG: 0.21, 0.23, 0.19 and 0.21; YW: 0.27, 0.33, 0.20 and 0.26; FAT: 0.30, 0.29, 0.29, 0.55; IMF: 0.45, 0.51, 0.33, 0.53 for MARG-RES, ADEQ-RES, MARG-CTRL and ADEQ-CTRL, respectively. The extent of genotype × environment interaction was modeled using two separate methods: reaction norms and multi-trait models. The genetic correlations were estimated using a multi-trait model for ADG, YW, FAT and IMF. Growth traits (ADG, YW) and FAT showed correlations less than 0.80 across the four different environments indicating genotype by environment interaction. For example, genetic correlation for ADG between MARG-CTRL and MARG-RES was 0.65 and 0.73 between ADEQ-RES and MARG-RES. In this example, the former genetic correlation corresponds to differences in post-weaning nutritional environment, and the later represents a nutritional difference imposed on dams (i.e., prenatal environment), potentially mediated via fetal programming. The reaction norm model results were in concordance with the multi-trait model, genotype by environment interaction had a higher effect on traits with a lower heritability.


Guiding Fellows to Independent Practice: Current Trends in Pediatric Emergency Medicine Fellow Supervision.
Recent studies highlight the importance of physician readiness to practice beyond graduate training. The Accreditation Council for Graduate Medical Education mandates that pediatric emergency medicine (PEM) fellows be prepared for independent practice by allowing "progressive responsibility for patient care." Prior unpublished surveys of program directors (PDs) indicate variability in approaches to provide opportunities for more independent practice during fellowship training. The aims of the study were to describe practices within PEM fellowship programs allowing fellows to work without direct supervision and to identify any barriers to independent practice in training. An anonymous electronic survey of PEM fellowship PDs was performed. Survey items were developed using an iterative modified Delphi process and pilot tested. Close-ended survey responses and demographic variables were summarized with descriptive statistics. Responses to open-ended survey items were reviewed and categorized by theme. Seventy two of 84 PDs (88%) responded to the survey; however, not all surveys were completed. Of the 68 responses to whether fellows could work without direct supervision (as defined by the Accreditation Council for Graduate Medical Education) during some part of their training, 31 (45.6%) reported that fellows did have this opportunity. In most programs, clinical independence was conditional on specific measures including the number of clinical hours completed, milestone achievement, and approval by the clinical competency committee. Reported barriers to fellow practice without direct oversight included both regulatory and economic constraints. Current training practices that provide PEM fellows with conditional clinical independence are variable. Future work should aim to determine best practices of entrustment, identify ideal transition points, and mitigate barriers to graduated responsibility.


On the classic and modern theories of matching.
Classic matching theory, which is based on Herrnstein's (1961) original matching equation and includes the well-known quantitative law of effect, is almost certainly false. The theory is logically inconsistent with known experimental findings, and experiments have shown that its central constant-k assumption is not tenable. Modern matching theory, which is based on the power function version of the original matching equation, remains tenable, although it has not been discussed or studied extensively. The modern theory is logically consistent with known experimental findings, it predicts the fact and details of the violation of the classic theory's constant-k assumption, and it accurately describes at least some data that are inconsistent with the classic theory.


Stress-strain and fatigue life numerical evaluation of two different dental implants considering isotropic and anisotropic human jaw.
Dental prostheses are currently a valid solution for replacing potential missing tooth or edentulism clinical condition. Nevertheless, the oral cavity is a dynamic and complex system: occlusal loads, external agents, or other unpleasant events can impact on implants functionality and stability causing a future revision surgery. One of the failure origins is certainly the dynamic loading originated from daily oral activities like eating, chewing, and so on. The aim of this paper was to evaluate, by a numerical analysis based on Finite Elements Method (FEM), and to discuss in a comparative way, firstly, the stress-strain of two different adopted dental implants and, subsequently, their fatigue life according to common standard of calculations. For this investigation, the jawbone was modeled accounting for either isotropic or anisotropic behavior. It was composed of cortical and cancellous regions, considering it completely osseointegrated with the implants. The impact of implants' fixture design, loading conditions, and their effect on the mandible bone was finally investigated, on the basis of the achieved numerical results. Lastly, the life cycle of the investigated implants was estimated according to the well-established theories of Goodman, Soderberg, and Gerber by exploiting the outcomes obtained by the numerical simulations, providing interesting conclusions useful in the dental practice.


Deep learning derived automated ASPECTS on non-contrast CT scans of acute ischemic stroke patients.
Ischemic stroke is the most common type of stroke, ranked as the second leading cause of death worldwide. The Alberta Stroke Program Early CT Score (ASPECTS) is considered as a systematic method of assessing ischemic change on non-contrast CT scans (NCCT) of acute ischemic stroke (AIS) patients, while still suffering from the requirement of experts' experience and also the inconsistent results between readers. In this study, we proposed an automated ASPECTS method to utilize the powerful learning ability of neural networks for objectively scoring CT scans of AIS patients. First, we proposed to use the CT perfusion (CTP) from one-stop stroke imaging to provide the golden standard of ischemic regions for ASPECTS scoring. Second, we designed an asymmetry network to capture features when comparing the left and right sides for each ASPECTS region to estimate its ischemic status. Third, we performed experiments in a large main dataset of 870 patients, as well as an independent testing dataset consisting of 207 patients with radiologists' scorings. Experimental results show that our network achieved remarkable performance, as sensitivity and accuracy of 93.7 and 92.4% in the main dataset, and 95.5 and 91.3% in the independent testing dataset, respectively. In the latter dataset, our analysis revealed a high positive correlation between the ASPECTS score and the prognosis of patients in 90DmRs. Also, we found ASPECTS score is a good indicator of the size of CTP core volume of an infraction. The proposed method shows its potential for automated ASPECTS scoring on NCCT images.


Nutritional Assessment and Maternal Perception of Toddler Body Size using Toddler Silhouette Scale in Nigeria a Developing Country.
The toddler silhouettes scales have been validated in the caucascian population in developing countries but in the African population, the use of these scales is yet to be evaluated. The aim of this study was to determine the perception of mothers on the body size of toddlers using a validated scale in an African population. This was a cross sectional study of 241 mothers and their toddlers. Study participants were recruited from the immunization and pediatric clinics. The mothers' perceptions of the body sizes of toddlers and their own child was determined with the use of a validated 7-scale toddler silhouette. Each mother also assessed their own child with the scale. Each child's anthropometry was documented. Majority of the mothers were able to correctly classify the underweight (95.0%) and overweight toddler silhouettes (95.7%). However, 30% of the respondents misclassified Silhouette 6 (overweight silhouette) as normal and 48.2% of the respondents misclassified a normal silhouette as underweight. The overall maternal accuracy in assessing their toddler size was 41.1%. There was a significant relationship between maternal accuracy and the maternal educational status, tribe, and toddler size. Toddler silhouette scales is a quick way of assessing the body size of children and could be of significant use in the developing countries. There is a need for caregivers to accurately assess the body size of their children as this will significantly influence the food mothers will give their children and thus children's eventual growth and development.


Association between psychological distress trajectories from adolescence to midlife and mental health during the pandemic: evidence from two British birth cohorts.
This paper examined whether distinct life-course trajectories of psychological distress from adolescence to midlife were associated with poorer mental health outcomes during the pandemic. We present a secondary analysis of two nationally representative British birth cohorts, the 1958 National Child Development Study (NCDS) and 1970 British Cohort Study (BCS70). We used latent variable mixture models to identify pre-pandemic longitudinal trajectories of psychological distress and a modified Poisson model with robust standard errors to estimate associations with psychological distress, life satisfaction and loneliness at different points during the pandemic. Our analysis identified five distinct pre-pandemic trajectories of psychological distress in both cohorts. All trajectories with prior symptoms of psychological distress irrespective of age of onset, severity and chronicity were associated with a greater relative risk of poorer mental health outcomes during the pandemic and the probability of poorer mental health associated with psychological distress trajectories remained fairly constant. The relationship was not fully attenuated when most recent pre-pandemic psychological distress and other midlife factors were controlled for. Whilst life-course trajectories with any prior symptoms of psychological distress put individuals at greater risk of poor mental health outcomes during the pandemic, those with chronic and more recent occurrences were at highest risk. In addition, prior poor mental health during the adult life-course may mean individuals are less resilient to shocks, such as pandemics. Our findings show the importance of considering heterogeneous mental health trajectories across the life-course in the general population in addition to population average trends.


Application of a Ge semi-conductor detector to whole-body counter.
To calibrate a whole-body counter, it is necessary to find a determination method for peak efficiencies of detectors used in the whole-body counter. For this purpose, peak efficiencies of a Ge semiconductor detector for point and volume sources were evaluated in the photon energy range 60-1836 keV by Monte Carlo simulation and experiment. It was found that the calculated peak efficiency curves as a function of energy without modelling of the actual sensitive region of the detector are similar in shape to those measured. The calculated peak efficiencies of the detector having an apparent dead layer (1 mm) were also found to agree with the experimental values (deviations from -10-24%). Consequently, the simulation method for peak efficiencies was validated. In addition, an optimum design for a whole-body counter with Ge semiconductor detectors was examined by simulation. This simulation provides a method to determine an optimum arrangement of detectors in a whole-body counter, offering a uniform response to various 137Cs distributions in a human body.