Persistent pulmonary nodular ground-glass opacity at thin-section CT: histopathologic comparisons.
To retrospectively compare pure pulmonary ground-glass opacity (GGO) nodules observed on thin-section computed tomography (CT) images with histopathologic findings. The institutional review board approved this study and waived informed consent. Histopathologic specimens were obtained from 53 GGO nodules in 49 patients. CT scans were assessed in terms of nodule size, shape, contour, internal characteristics, and the presence of a pleural tag. The findings obtained were compared with histopathologic results. Differences in thin-section CT findings according to histopathologic diagnoses were analyzed by using the Kruskal-Wallis test or Fisher exact test. Of 53 nodules in 49 patients (20 men, 29 women; mean age, 54 years; range, 29-78 years), 40 (75%) proved to be broncholoalveolar cell carcinoma (BAC) (n=36) or adenocarcinoma with predominant BAC component (n=4), three (6%) atypical adenomatous hyperplasia, and 10 (19%) nonspecific fibrosis or organizing pneumonia. No significant differences in morphologic findings on thin-section CT scans were found among the three diseases (all P>0.05). A polygonal shape (25%, 10 of 40 nodules) and a lobulated or spiculated margin (45%, 18 of 40) in BAC or adenocarcinoma with predominant BAC component were caused by interstitial fibrosis or infiltrative tumor growth. A polygonal shape and a lobulated or spiculated margin were observed in two (20%) and three (30%) of 10 nodules, respectively, in organizing pneumonia/fibrosis were caused by granulation tissue aligned in a linear manner in perilobular regions with or without interlobular septal thickening. About 75% of persistent pulmonary GGO nodules are attributed to BAC or adenocarcinoma with predominant BAC component, and at thin-section CT, these nodules do not manifest morphologic features that distinguish them from other GGO nodules with different histopathologic diagnoses.


Morphological Characteristics of the Oropharyngeal Cavity (Tongue, Palate and Laryngeal Entrance) in the Eurasian Coot (Fulica atra, Linnaeus, 1758).
The present study represents the first definitive anatomical description of the oropharyngeal cavity of the coot Fulica atra. For this purpose, the organs of six birds were prepared to examine grossly and by SEM and stereomicroscope. The oval lingual apex had multiple overlapping branched acicular processes on its anterior and lateral border. The lingual apex and body had multiple caudally directed filiform-like papillae. By stereomicroscopy, the lingual root had a characteristic appearance and consisted of four parts. The openings of the anterior glands were present on the dorsal lingual surface of the body, while the projected papillae with wide openings of the posterior glands were present on the dorsal surface of lingual root. There was a row of caudally directed pharyngeal papillae at the caudal border of the laryngeal mound. Grossly, the pharyngeal papillae arrangement took a W-shape, while by stereomicroscopy was observed to be heart shape. The palate was divided into two regions: a small rostral non-papillary and a large caudal papillary region, but the rostral region was characterized by the presence of three longitudinal ridges. The papillary crest had two paramedian longitudinal papillary rows, which continued caudally until the beginning of the third median row. The freely distributed papillae took a caudolateral direction, while the papillae encircling the rostral part of choanal cleft took a caudomedial direction. There was a transverse papillary row between the two parts of choanal cleft. There was a transverse papillary row between the caudal border of the infundibular cleft and oesophagus.


Ability of bacteriophage in resolving wound infection caused by multidrug-resistant Acinetobacter baumannii in uncontrolled diabetic rats.
Acinetobacter baumannii, a substantial nosocomial pathogen, has developed resistance to almost all available antimicrobial drugs. Bacteriophage therapy is a possible alternative treatment for multidrug-resistant (MDR) bacterial infections. In this study, we have successfully isolated bacteriophage active against clinical strains of A. baumannii by enrichment from hospital sewage sludge using representatives of those strains. The bacteriophage isolated against A. baumannii formed plaques against beta-lactamases producing strains of A. baumannii. The utility of bacteriophage specific for A. baumannii to resolve wound infection in uncontrolled diabetic rats was evaluated. Five groups of uncontrolled diabetic rats were used. Group I was noninfected (Control), Group II was infected with MDR A. baumannii and challenged with bacteriophage, Group III was infected with MDR A. baumannii, Group IV was infected with MDR A. baumannii and challenged with antibiotic colistin, and Group V consisted of noninfected rats and sprayed with phage (Phage control). A significant decrease in infection, period of epithelization, and wound contraction was observed in the phage-challenged group when compared with antibiotic-treated uncontrolled diabetic rats and the control group. To conclude the study, new insights are provided into the biology of the broad host range of A. baumannii phage, demonstrating that A. baumannii phage has prospects for the treatment of infections caused by the MDR A. baumannii.


Dihydromyricetin affects BDNF levels in the nervous system in rats with comorbid diabetic neuropathic pain and depression.
Diabetic neuropathic pain (DNP) and depression (DP) are the common complications in patients with diabetes. The purpose of our research was to observe whether brain-derived neurotrophic factor (BDNF) levels and tropomyosin receptor kinase B (TrkB) in the nervous system have effects on rats with comorbid DNP and DP, and to determine whether dihydromyricetin (DHM) may influence BDNF/ TrkB pathway to mitigatethe comorbidity. The study showed that DHM treatment could attenuates pain and depressive behavior in DNP and DP combined rats. Compared with the control group, the expression level of BDNF/TrkB in the hippocampus of DNP + DP group were reduced, while the expression levels in the spinal cord and DRG were increased. However, after treatment with DHM, those changes were reversed. Compared with the control group, the level of IL-1β and TNF-α in the hippocampus, spinal cord and DRG in the DNP + DP group was significantly increased, and DHM treatment could reduce the increase. Thus our study indicated that DHM can relief symptoms of DNP and DP by suppressing the BDNF/TrkB pathway and the proinflammatory factor, and BDNF/TrkB pathway may be an effective target for treatment of comorbid DNP and DP.


What is meant by risk-based environmental quality criteria?
Criteria for the quality of water and other media are often said to be risk based. However, the relationship between the process of criterion setting and risk assessment has not been clear. This article shows that the conventional framework for risk assessment may be easily modified to represent criterion development. The critical difference is that conventional risk assessments solve an exposure-response model for an expected exposure to estimate an effect, but criterion assessments solve the same model for a benchmark effect to estimate an upper limit to acceptable exposures. Hence, the critical step in criterion setting is the determination of an effect metric that can be modeled and that represents the environmental goal. The same process applies to equivalent assessments, such as deriving screening benchmarks and remedial goals.


Instanton theory for Fermi's golden rule and beyond.
Instanton theory provides a semiclassical approximation for computing quantum tunnelling effects in complex molecular systems. It is typically applied to proton-transfer reactions for which the Born-Oppenheimer approximation is valid. However, many processes in physics, chemistry and biology, such as electron transfers, are non-adiabatic and are correctly described instead using Fermi's golden rule. In this work, we discuss how instanton theory can be generalized to treat these reactions in the golden-rule limit. We then extend the theory to treat fourth-order processes such as bridge-mediated electron transfer and apply the method to simulate an electron moving through a model system of three coupled quantum dots. By comparison with benchmark quantum calculations, we demonstrate that the instanton results are much more reliable than alternative approximations based on superexchange-mediated effective coupling or a classical sequential mechanism. This article is part of the theme issue 'Chemistry without the Born-Oppenheimer approximation'.


Racotumomab-alum vaccine for the treatment of non-small-cell lung cancer.
Racotumomab-alum vaccine is an anti-idiotypic vaccine able to mimic the tumor-associated antigen NeuGcGM3. Different Phase I clinical trials and compassionate use studies demonstrated its low toxicity and capacity to induce a strong anti-NeuGcGM3 response, able to bind and directly kill tumor cells expressing the antigen. A Phase II/III randomized double-blind clinical trial in advanced non-small cell lung cancer patients showed a significant improvement in overall survival and progression-free survival for racotumomab-alum versus placebo. Patients who developed anti-NeuGcGM3 antibodies capable of binding and killing NeuGcGM3 expressing tumor cells showed significantly longer median survival times. The impact of using racotumomab-alum as switch maintenance followed by second-line therapy is currently being explored in a new randomized, multinational Phase III study.


Management of Central Venous Access Device-Associated Skin Impairment: An Evidence-Based Algorithm.
Patients relying on central venous access devices (CVADs) for treatment are frequently complex. Many have multiple comorbid conditions, including renal impairment, nutritional deficiencies, hematologic disorders, or cancer. These conditions can impair the skin surrounding the CVAD insertion site, resulting in an increased likelihood of skin damage when standard CVAD management practices are employed. Supported by the World Congress of Vascular Access (WoCoVA), developed an evidence- and consensus-based algorithm to improve CVAD-associated skin impairment (CASI) identification and diagnosis, guide clinical decision-making, and improve clinician confidence in managing CASI. A scoping review of relevant literature surrounding CASI management was undertaken March 2014, and results were distributed to an international advisory panel. A CASI algorithm was developed by an international advisory panel of clinicians with expertise in wounds, vascular access, pediatrics, geriatric care, home care, intensive care, infection control and acute care, using a 2-phase, modified Delphi technique. The algorithm focuses on identification and treatment of skin injury, exit site infection, noninfectious exudate, and skin irritation/contact dermatitis. It comprised 3 domains: assessment, skin protection, and patient comfort. External validation of the algorithm was achieved by prospective pre- and posttest design, using clinical scenarios and self-reported clinician confidence (Likert scale), and incorporating algorithm feasibility and face validity endpoints. The CASI algorithm was found to significantly increase participants' confidence in the assessment and management of skin injury (P = .002), skin irritation/contact dermatitis (P = .001), and noninfectious exudate (P < .01). A majority of participants reported the algorithm as easy to understand (24/25; 96%), containing all necessary information (24/25; 96%). Twenty-four of 25 (96%) stated that they would recommend the tool to guide management of CASI.


Periodical cicadas disrupt trophic dynamics through community-level shifts in avian foraging.
Once every 13 or 17 years within eastern North American deciduous forests, billions of periodical cicadas concurrently emerge from the soil and briefly satiate a diverse array of naive consumers, offering a rare opportunity to assess the cascading impacts of an ecosystem-wide resource pulse on a complex food web. We quantified the effects of the 2021 Brood X emergence and report that more than 80 bird species opportunistically switched their foraging to include cicadas, releasing herbivorous insects from predation and essentially doubling both caterpillar densities and accumulated herbivory levels on host oak trees. These short-lived but massive emergence events help us to understand how resource pulses can rewire interaction webs and disrupt energy flows in ecosystems, with potentially long-lasting effects.


Monovalent Omicron COVID-19 vaccine triggers superior neutralizing antibody responses against Omicron subvariants than Delta and Omicron bivalent vaccine.
The continuous evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants poses a challenge to determine the optimal updated composition of the coronavirus disease 2019 (COVID-19) vaccine. The present study aimed to investigate the immunogenicity of the Delta monovalent vaccine, the Omicron monovalent vaccine, and the Delta and Omicron BA.1 bivalent vaccine. Three COVID-19 vaccines were designed using the heterologous DNA prime-protein boost strategy, with each vaccine containing either Delta receptor-binding domain (RBD) of the spike protein, Omicron RBD, or both Delta and Omicron antigens. Temporal serum antibody binding titers and neutralizing antibody titers induced by the three vaccines in New Zealand White rabbits were analyzed. To further dissect the vaccine elicited antibodies (mAb) responses at the molecular level, a panel of rabbit monoclonal antibodies (RmAbs) was generated by a high-throughput single B cell sorting and discovery pipeline and further comprehensively characterized. The Omicron monovalent vaccine induced higher antibody binding titers and neutralization activities than the Delta and Omicron bivalent vaccine. Four RmAbs with robust neutralization capacity were isolated from rabbits immunized with the Omicron or Delta monovalent vaccine. Notably, 9E11 isolated from the Omicron monovalent vaccine group neutralized all the Omicron subvariants with an IC50 value ranging from 1.5 to 503.6 ng/mL; thus, this vaccine could serve as a prophylactic and therapeutic intervention. Given the increasing incidence of COVID-19 cases due to the Omicron variant, RBD from the Omicron strain could serve as a candidate immunogen that can induce higher neutralization activities against the SARS-CoV-2 Omicron sublineages.


Recent Advances on Graphene Quantum Dots for Bioimaging Applications.
Being a zero-dimensional (0D) nanomaterial of the carbon family, graphene quantum dots (GQDs) showed promising biomedical applications owing to their ultra-small size, non-toxicity, biocompatibility, excellent photo stability, tunable fluorescence, and water solubility, etc., thus capturing a considerable attention in biomedical field. This review summarizes the recent advances made in the research field of GQDs and place special emphasis on their bioimaging applications. We briefly introduce the synthesis strategies of GQDs, including top-down and bottom-up strategies. The bioimaging applications of GQDs are also discussed in detail, including optical [fluorescence (FL)], two-photon FL, magnetic resonance imaging (MRI), and dual-modal imaging. In the end, the challenges and future prospects to advance the clinical bioimaging applications of GQDs have also been addressed.


Salvia clandestina L.: unexploited source of danshensu.
We report the characterisation of Salvia clandestina L. shoots and roots aqueous extract using HPLC-ESI/MS-TOF. Among the 29 compounds detected, we observed the presence of danshensu (3-(3,4-dihydroxy-phenyl) 2-hydroxy-propinic acid), a powerful antioxidant and a cardio-protective agent. The danshensu content found in the shoots of S. clandestina was considerable (4.96 mg g-1 DW) if compared with previous studies on S. miltiorrhiza Bunge, the main source of this compound. We also determined the total phenolic concentration and we evaluated their antioxidant activity by ABTS, FRAP and Superoxide anion scavenging methods. All the three assays confirmed a greater antioxidant activity for the shoots in comparison to roots. S. clandestina shoots may represent a valuable and natural unexploited source of danshensu and other phenolic compounds, so that it may be useful for future applications in functional foods and pharmaceutical industries.


Utilisation of antimalarial drugs by pregnant women attending the antenatal clinic at Muhimbili Medical Centre, Dar es Salaam.
Two hundred women in early second trimester were recruited in a study to monitor the utilisation of antimalarial drugs prescribed for prophylaxis or treatment of malaria during their attendance at the antenatal clinic of Muhimbili Medical Centre. Information regarding the use of antimalarial drugs was obtained during an interview using a structured questionnaire and antenatal cards. The study revealed that 51.5% had taken antimalarials for treatment of acute malaria while 23.5% had taken for prophylaxis. There was thus a total exposure of 75%. most of them were exposed to choloroquine (69.5l%). There was no statistically significant association between the taking of chloroquine and its presence in urine and between the level of education and the taking of chloroquine prophylactically.


A functional polymorphism in the manganese superoxide dismutase gene and diabetic nephropathy.
Oxidative stress has been suggested to contribute to the development of diabetic nephropathy. Manganese superoxide dismutase (MnSOD) protects the cells from oxidative damage by scavenging free radicals. The demand for antioxidants is increased by smoking, which could disturb the balance between antioxidants and radicals. The present study aimed to determine whether a valine/alanine polymorphism in MnSOD (V16A, rs4880), alone or in combination with smoking, can contribute to development of diabetic nephropathy in 1,510 Finnish and Swedish patients with type 1 diabetes. Overt diabetic nephropathy (n = 619) was defined as having an albumin excretion rate (AER) >200 microg/min or renal replacement therapy; incipient diabetic nephropathy was defined as having an AER of 20-200 microg/min (n = 336). The control subjects had diabetes duration of >or=20 years, without albuminuria (AER <20 microg/min) and without antihypertensive treatment (n = 555). In addition to male sex and elevated A1C, smoking was significantly associated with diabetic nephropathy (overt plus incipient), odds ratio (OR) 2.00 (95% CI 1.60-2.50). When controlling for age at onset, diabetes duration, A1C, smoking, and sex, the Val/Val genotype was associated with an increase in risk of diabetic nephropathy (1.32 [1.00-1.74], P = 0.049). When evaluating the combined effect of genotype and smoking, we used logistic regression with stratification according to smoking status and genotype. The high-risk group (ever smoking plus Val/Val genotype) had 2.52 times increased risk of diabetic nephropathy (95% CI 1.73-3.69) compared with the low-risk group, but no departure from additivity was found. Our results indicate that smoking and homozygosity for the MnSOD Val allele is associated with an increased risk of diabetic nephropathy, which supports the hypothesis that oxidative stress contributes to the development of diabetic nephropathy.


Calmodulin inhibitors and 8-(N,N-diethylamino)-octyl-3,4,5-trimethoxybenzoate do not prevent the inhibitory effect of prostaglandin F2 alpha on cyclic AMP production in isolated rat corpora lutea.
In the rat corpus luteum, prostaglandin F2 alpha (PGF2 alpha) rapidly inhibits LH-induced cyclic AMP (cAMP) production when given in vivo or to isolated corpora lutea, but not to broken-cell preparations. The suggestion that increased cytosolic calcium concentration mediates PGF2 alpha action was investigated in corpora lutea of pseudopregnancy induced in immature rats by administration of pregnant mare serum gonadotrophin (15 i.u.). Isolated 10-day-old corpora lutea were incubated for 90 min with LH (5 micrograms/ml), PGF2 alpha (10 mumol/l) and other additions, and cAMP concentration in the tissue was estimated. The putative inhibitor of intracellular calcium release or action, 8-(n,N-diethylamino)-octyl-3,4,5-trimethoxybenzoate (TMB-8; 30 or 150 mumol/l), did not abolish the effect of PGF2 alpha. Similarly ineffective was the combination of TMB-8 (150 mumol/l) and calcium-depleted medium (free ionized calcium concentration, 30 nmol/l). Calmodulin inhibitors of three different chemical structures were then tested. The phenothiazine trifluoperazine, at 300 as well as 30 mumol/l, did not interfere with the inhibitory effect of PGF2 alpha on cAMP, while suppressing (at 300 mumol/l) progesterone secretion in LH-treated tissue. Furthermore, inhibition by PGF2 alpha was not impaired by pimozide, a diphenylbutylpiperidine (25 and 50 mumol/l) nor by N-(6-aminohexyl)-5-chloro-1-naphthalene sulphonamide (W-7; 15 and 45 mumol/l). In the presence of LH alone, W-7 (45 mumol/l) inhibited and TMB-8 (30 mumol/l augmented cAMP accumulation, indicating that the luteal tissue was effectively exposed to these compounds. Thus, drugs known to inhibit calcium- and calmodulin-dependent processes in a variety of tissues did not abolish the inhibitory action of PGF2 alpha on luteal cAMP production.


[Fine physical mapping of yeast chromosome V].
Electrophoretic karyotype of yeast strain A364a was obtained by pulsed field gel electrophoresis and the position of chromosome V on such karyotype was determined by means of dot hybridization with chromosome V-specific probe URA3. By cloning partially digested BamHI fragments of this chromosome DNA into integrative vector Yip5, a gene library specific to this chromosome was constructed. The number of the recombinants was much more than theoretically required. After screening probe-homologous fragments from this library and analysing such fragments with restriction enzymes BamHI, EcoRI, HindIII, PstI, and SalI, a fine physical map covering about 9.4% of A364a chromosome V (which was estimated as 620kb) was constructed. Further colony hybridization with boundary clones will enable us to "walk" throughout the whole chromosome.


Resting-state brain connectivity correlates of musical sophistication.
A growing body of research has investigated how performing arts training, and more specifically, music training, impacts the brain. Recent meta-analytic work has identified multiple brain areas where activity varies as a function of levels of musical expertise gained through music training. However, research has also shown that musical sophistication may be high even without music training. Thus, we aim to extend previous work by investigating whether the functional connectivity of these areas relates to interindividual differences in musical sophistication, and to characterize differences in connectivity attributed to performing arts training. We analyzed resting-state functional magnetic resonance imaging from n = 74 participants, of whom 37 received performing arts training, that is, including a musical instrument, singing, and/or acting, at university level. We used a validated, continuous measure of musical sophistication to further characterize our sample. Following standard pre-processing, fifteen brain areas were identified a priori based on meta-analytic work and used as seeds in separate seed-to-voxel analyses to examine the effect of musical sophistication across the sample, and between-group analyses to examine the effects of performing arts training. Connectivity of bilateral superior temporal gyrus, bilateral precentral gyrus and cerebellum, and bilateral putamen, left insula, and left thalamus varied with different aspects of musical sophistication. By including these measures of these aspects as covariates in post hoc analyses, we found that connectivity of the right superior temporal gyrus and left precentral gyrus relate to effects of performing arts training beyond effects of individual musical sophistication. Our results highlight the potential role of sensory areas in active engagement with music, the potential role of motor areas in emotion processing, and the potential role of connectivity between putamen and lingual gyrus in general musical sophistication.


The in vitro antiviral activity of isoprinosine on simian rotavirus (SA-11).
1. The antiviral effect of isoprinosine on simian rotavirus (SA-11) replication was studied using MA-104 cell cultures from Rhesus monkey fetal kidney. 2. Isoprinosine (N,N-dimethylamino-2-propanol-p-acetamidobenzoate in association with inosine) added after viral infection (therapeutic test) inhibited viral replication by more than 90%. In these experiments, the drug was added to the medium and replaced daily at concentrations varying from 62.5 micrograms/ml to 1 mg/ml. Viral inhibition activity was dependent on drug concentration. No antiviral effect was observed when isoprinosine was tested without replacement (200-500 micrograms/ml). 3. When isoprinosine (1 mg/ml) was added to cell cultures only before viral infection (prophylactic test), inhibition of viral replication occurred but was less than 90%. Inhibition by less than 90% is not considered to be significant in this type of test. 4. Isoprinosine inhibited synthesis of both viral antigen (protein) and viral double-stranded nucleic acid, as monitored by immunofluorescence and acridine orange staining, respectively. Inhibition of synthesis of viral macromolecules increased with drug concentration.


Abuse-deterrent formulations: part 2: commercial products and proprietary technologies.
Increased misuse and abuse of prescription pain medications has driven extensive research and development to produce what are best known as abuse-deterrent formulations (ADFs). The ADFs are intended to prevent, impede or discourage physical and chemical tampering while still being able to provide safe and accurate delivery of an abusable medication for therapeutic benefit. This review primarily focuses on patents and company literature regarding the formulations, manufacturing and physiochemical properties of abuse-deterrent compositions. Also included are journal articles with relevance to the development of these novel technologies. Particular attention is given to oral dosage forms with applications found in prescription drug products, over-the-counter medications and proprietary technologies in development. Overall, the formulations of 14 drug products, 2 meth-resistant cold products and 17 pharmaceutical proprietary technologies are explored in detail. Despite the introduction of a wide range of formulation and technology interventions with different deterrence potential, the progression of these technologies seems to be moving from inhibiting only one type of abuse to stopping multiple types of tampering methods. Information on inherent strengths and weaknesses of various formulations can be utilized in the development of more robust and resistant ADF in the future.


Connecting the Dots: Potential Interactions Between Sex Hormones and the Circadian System During Memory Consolidation.
Both the circadian clock and sex hormone signaling can strongly influence brain function, yet little is known about how these 2 powerful modulatory systems might interact during complex neural processes like memory consolidation. Individually, the molecular components and action of each of these systems have been fairly well-characterized, but there is a fundamental lack of information about how these systems cooperate. In the circadian system, clock genes function as timekeeping molecules that convey time-of-day information on a well-stereotyped cycle that is governed by the suprachiasmatic nucleus. Keeping time is particularly important to synchronize various physiological processes across the brain and body, including those that regulate memory consolidation. Similarly, sex hormones are powerful modulators of memory, with androgens, estrogens, and progestins, all influencing memory consolidation within memory-relevant brain regions like the hippocampus. Despite clear evidence that each system can influence memory individually, exactly how the circadian and hormonal systems might interact to impact memory consolidation remains unclear. Research investigating either sex hormone action or circadian gene function within memory-relevant brain regions has unveiled several notable places in which the two systems could interact to control memory. Here, we bring attention to known interactions between the circadian clock and sex hormone signaling. We then review sex hormone-mediated control of memory consolidation, highlighting potential nodes through which the circadian system might interact during memory formation. We suggest that the bidirectional relationship between these two systems is essential for proper control of memory formation based on an animal's hormonal and circadian state.


Augmented Reality in the Health Domain: Projecting Spatial Augmented Reality Visualizations on a Perceiver's Body for Health Communication Effects.
An experiment is reported that studied the effects of spatial embodiment in augmented reality on medical attitudes about the self. College students (N = 90) viewed public service announcements (PSAs) with overlaid virtual fetuses and X-rayed images of lungs on various interfaces representing embodiment-a two-dimensional screen, a three-dimensional (3D) mannequin, and the participants' bodies (3D). Results indicated that PSA messages with richer embodied interfaces increase the sense of "being there," also known as spatial presence (SP), in sequential order; this leads to increased negative emotion regarding smoking cigarettes and an increased willingness to engage with a cigarette cessation campaign. When the SP mediates the dual model process, only affective attitudes increase the behavioral intention to engage with the campaign.


[New challenges in thoracic surgery as exemplified in asbestos exposure and mesothelioma treatment].
The increasing production and use of asbestos has induced a steadily increasing incidence of malignant mesothelioma. Diagnostic difficulties persist and the disease may remain undiagnosed in spite of multiple fluid aspirations and percutaneous needle biopsies. Thoracic surgery efficiently contributes to the diagnostic yield by thoracoscopy and, with unilateral disease, in functionally operable patients, preferably by diagnostic thoracotomy. In suitable patients this can be extended to either palliative tumour pleurectomy or total pleuro-pneumonectomy en bloc with resection of the pericardium and the diaphragm. The primary mortality of this procedure has dropped from formerly thirty to now well below 10% for both types of resection. Along with any kind of thoracotomy a lung biopsy should be performed for search of asbestos bodies in the parenchyma. This will facilitate not only the differential diagnosis but also the answer to the question of aetiology in support of the patients' and their families' claim for compensation to be paid. Unfortunately, although surgery has advantages compared to chemo- or radiotherapy and improves the quality of life, it fails to achieve cure except in a few favourable cases.


[Immunotherapy and hyperthermia for the treatment of patients with advanced or recurrent colorectal cancer].
We treated 226 patients with advanced or recurrent colorectal cancer using hyperthermia or immunotherapy between July 2005 and September 2012. Clinical benefit (complete response [CR], partial response [PR], and long stable disease [SD] for more than 6 months) was observed in 30 patients (13.3%), including CR in 5 patients. The effective rate of immunotherapy increased from 14.3% to 16.1% using hyperthermia. The effective rate of hyperthermia was 3.9%. Of the 30 effectively treated patients, liver metastases disappeared in 2 patients treated with hyperthermia alone, and lung metastases disappeared in 2 patients treated with immunotherapy alone. In the remaining 26 effectively treated patients, multiple metastases were observed in solid organs. Both hyperthermia and immunotherapy were administered and were found to be effective in the treatment of patients with advanced or recurrent colorectal cancer.


[Clinical observation of "Yinqi Guiyuan needles therapy" combined with moxibustion at Yongquan (KI 1) on perimenopausal insomnia with heart-kidney imbalance].
To observe the clinical efficacy of "Yinqi Guiyuan needles therapy" combined with moxibustion at yongquan (KI 1) on perimenopausal insomnia (PMI) with heart-kidney imbalance. One hundred patients of PMI with heart-kidney imbalance were randomly divided into a medication group and an acupuncture group, 50 cases in each group. In the medication group, diazepam and oryzanol were given. "Yinqi Guiyuan needles therapy" combined with moxibustion at yongquan (KI 1) were applied in the acupuncture group. The treatment was given for 2 courses, 10 days as a course. Before and after treatment, the Pittsburgh sleep quality index (PSQI) scale was used to evaluate the improvement of sleep quality in the two groups, and the clinical efficacy was compared. After 2 courses of treatment, the total PSQI score was (4.88±1.80) in the acupuncture group, which was significantly lower than (8.00±1.93) in the medication group, and the difference was statistically significant (P<0.05). Except for the sleep efficiency, the scores of other components in the acupuncture group were lower than those in the medication group, and the differences were statistically significant (all P<0.05). The total effective rate was 90.0% (45/50) in the acupuncture group and 68.0% (34/50) in the medication group. The difference was statistically significant (P<0.05). There was no obvious adverse reactions in entire course of the treatment in the acupuncture group and the safety was satisfactory. "Yinqi Guiyuan needles therapy" combined with moxibustion at Yongquan (KI 1) on PMI with heart-kidney imbalance has good clinical effect.


Identification and molecular structure analysis of a new noncoding RNA, a sbRNA homolog, in the silkworm Bombyx mori genome.
The small noncoding group of RNAs called stem-bulge RNAs (sbRNAs), first reported in Caenorhabditis elegans, is described as molecules homologous to the Y RNAs, a specific class of noncoding RNAs that is present in vertebrates. This homology indicates the possibility of the existence of sbRNAs in other invertebrate organisms. In this work, we used bioinformatic tools and conserved sequences of sbRNAs from C. Elegans and Y RNAs to search for homologous sbRNA sequences in the Bombyx mori genome. This analysis led to the discovery of one noncoding gene, which was translated into RNA segments and comparatively analysed with segments from human and hamster Y RNAs and C. elegans sbRNAs in molecular dynamic simulations. This gene represents the first evidence for a new sbRNA-like noncoding RNA, the BmsbRNA gene, in this Lepidoptera genome.


Stability of fatty acyl-coenzyme A thioester ligands of hepatocyte nuclear factor-4alpha and peroxisome proliferator-activated receptor-alpha.
Although long-chain fatty acyl-coenzyme A (LCFA-CoA) thioesters are specific high-affinity ligands for hepatocyte nuclear factor-4alpha (HNF-4alpha) and peroxisome proliferator-activated receptor-alpha (PPARalpha), X-ray crystals of the respective purified recombinant ligand-binding domains (LBD) do not contain LCFA-CoA, but instead exhibit bound LCFA or have lost all ligands during the purification process, respectively. As shown herein: (i) The acyl chain composition of LCFA bound to recombinant HNF-4alpha reflected that of the bacterial LCFA-CoA pool, rather than the bacterial LCFA pool. (ii) Bacteria used to produce the respective HNF-4alpha and PPARalpha contained nearly 100-fold less LCFA-CoA than LCFA. (iii) Under conditions used to crystallize LBD (at least 3 wk at room temperature in aqueous buffer), 16:1-CoA was very unstable in buffer alone. (iv) In the presence of the respective nuclear receptor (i.e., HNF-4alpha and PPARalpha), LBD 70-75% of 16:1-CoA was degraded after 1 d at room temperature in the crystallization buffer, whereas as much as 94-97% of 16:1-CoA was degraded by 3 wk. (v) Cytoplasmic LCFA-CoA binding proteins such as acyl-CoA binding protein, sterol carrier protein-2, and liver-FA binding protein slowed the process of 16:1-CoA degradation proportional to their respective affinities for this ligand. Taken together, these data for the first time indicated that the absence of LCFA-CoA in the crystallized HNF-4alpha and PPARalpha was due to the paucity of LCFA-CoA in bacteria as well as to the instability of LCFA-CoA in aqueous buffers and the conditions used for LBD crystallization. Furthermore, instead of protecting bound LCFA-CoA from autohydrolysis like several cytoplasmic LCFA-CoA binding proteins, these nuclear receptors facilitated LCFA-CoA degradation.


Olfactory receptor cell staining using horseradish peroxidase.
Iontophoretic injection of horseradish peroxidase into severed olfactory nerve fascicles has been used to stain salamander olfactory receptor cell somata, their associated nerves, and their axonal terminations in the glomerular layer of the olfactory bulb. This technique gives homogeneous, Golgi-like staining of individually identifiable receptor cells and has permitted preliminary mapping of the topographical relationship between the loci of receptors in the olfactory mucosa and sites of their termination in the glomerular layer in the olfactory bulb.


Hydrogen-Bond Donors in Drug Design.
Hydrogen-bond donors are seen to cause more problems for drug designers than hydrogen-bond acceptors. Most of the polarity in drug-like compounds comes from hydrogen-bond acceptors since they typically exceed the hydrogen-bond donors in number and are more heavily solvated on an individual basis. The implications of this polarity imbalance for optimization of permeability and aqueous solubility are discussed. A factor that should be considered in optimization of ligand recognition by targets is that the presence of a hydrogen-bond donor generally implies that a hydrogen-bond acceptor is also present (but not vice versa). Frustrated solvation and secondary electrostatic interactions result from aligned hydrogen-bond donors and acceptors, and the design opportunities presented by these phenomena are discussed. Hydrogen-bond donors based on oxygen, nitrogen and carbon are compared as target recognition elements, and halogen- and chalcogen-bond donors are discussed as hydrogen-bond donor equivalents.


[Analysis of de novo copy number variations in a family affected with autism spectrum disorders using high-resolution array-based comparative genomic hybridization].
To analyze de novo copy number variations (CNVs) in a Chinese family affected with autism spectrum disorders (ASD). Affymetrix Cytogenetics Whole Genome 2.7M Array assay was performed to identify potential CNVs in four members from the family. A total of 89 de novo CNV regions were identified in the autistic siblings. The CNV regions in total have exceeded 1/1000 of the lengths of chromosomes 5, 11 and 14. In addition, de novo CNV regions were also identified at 3p26.1, 4q22.2, and 5p15.2, which encompassed 10 genes associated with nerve development including GRM7, GRID2 and CTNND2. A number of nerve development associated genes were at the de novo CNV sites, which may provide new clues for genetic research of ASD. High-resolution array-comparative genomic hybridization is an effective method for detecting submicroscopic chromosomal imbalances.


The Peaceful Mind manual: a protocol for treating anxiety in persons with dementia.
Anxiety disorders are highly prevalent among individuals with dementia and have a significant negative impact on their lives. Peaceful Mind is a form of cognitive-behavioral therapy for anxiety in persons with dementia. The Peaceful Mind manual was developed, piloted, and modified over 2 years. In an open trial and a small randomized, controlled trial, it decreased anxiety and caregiver distress. The treatment meets the unique needs of individuals with dementia by emphasizing behavioral rather than cognitive interventions, slowing the pace, limiting the material to be learned, increasing repetition and practice, using cues to stimulate memory, including a friend or family member in treatment as a coach, and providing sessions in the home. The manual presented here includes modules that teach specific skills, including awareness, breathing, calming self-statements, increasing activity, and sleep management, as well as general suggestions for treatment delivery.


Staging accuracy of endoscopic ultrasound based on pathologic analysis after minimally invasive esophagectomy.
Endoscopic ultrasonography (EUS) is a common staging modality used in patients with esophageal cancer. The objective of this analysis was to evaluate the accuracy and sensitivity of EUS in determining the depth of penetration (T stage) and nodal status (N stage) in patients with esophageal cancer who underwent minimally invasive esophagectomy (MIE). A retrospective analysis of all patients at a university hospital who underwent preoperative EUS followed by MIE for cancer was performed. We compared the results of preoperative EUS to final pathologic analyses of the esophageal specimen, examining the accuracy of EUS staging. Ninety-five patients with esophageal cancer who underwent MIE had preoperative EUS. Twenty-four of the 95 patients were excluded for lack of a repeat EUS after neoadjuvant therapy before resection. Hence, 71 patients were evaluated for the accuracy of EUS staging. The accuracy of EUS for T0 disease was 80 per cent; T1 disease was 75 per cent; T2 disease was 39 per cent; and T3 disease was 88 per cent. The overall EUS accuracy for T stage was 72 per cent with overstaging occurring mostly for pathologic T1 tumors in 18 per cent and understaging occurring mostly for pathologic T3 tumors in 11 per cent. The sensitivity and specificity for detection of nodal involvement were 79 per cent and 74 per cent, respectively. However the accuracy for T and N staging by EUS after neoadjuvant therapy decreased to 63 per cent and 38 per cent, respectively. Endoscopic ultrasound in the absence of neoadjuvant therapy is a relatively accurate and sensitive modality for determining the depth of tumor penetration and the presence of nodal disease in patients with esophageal carcinoma. The accuracy for T and N staging is less reliable after neoadjuvant therapy.


Budd-Chiari Syndrome: An Uncommon Cause of Chronic Liver Disease that Cannot Be Missed.
Budd-Chiari syndrome (BCS), or hepatic venous outflow obstruction, is a rare cause of liver disease that should not be missed. Variable clinical presentation among patients with BCS necessitates a high index of suspicion to avoid missing this life-threatening diagnosis. BCS is characterized as primary or secondary, depending on etiology of venous obstruction. Most patients with primary BCS have several contributing risk factors leading to a prothrombotic state. A multidisciplinary stepwise approach is integral in treating BCS. Lifelong anticoagulation is recommended. Long-term monitoring of patients for development of cirrhosis, complications of portal hypertension, hepatocellular carcinoma, and progression of underlying diseases is important.


Glioma Subclassifications and Their Clinical Significance.
The impact of targeted therapies in glioma has been modest. All the therapies that have demonstrated a significant survival benefit for gliomas in Phase III trials, including radiation, chemotherapy (temozolomide and PCV [procarbazine, lomustine, vincristine]), and tumor-treating fields, are based on nonspecific targeting of proliferating cells. Recent advances in the molecular understanding of gliomas suggest some potential reasons for the failure of more targeted therapies in gliomas. Specifically, the histologic-based glioma classification is composed of multiple different molecular subtypes with distinct biology, natural history, and prognosis. As a result of these insights, the diagnosis and classification of gliomas have recently been updated by the World Health Organization. However, these changes and other novel observations regarding glioma biomarkers and subtypes highlight several clinical challenges. First, the field is faced with the difficulty of reinterpreting the results of prior studies and retrospective data using the new classifications to clarify prognostic assessments and treatment recommendations for patients. Second, the new classifications and insights require rethinking the design and stratification of future clinical trials. Last, these observations provide the essential framework for the development and testing of new specific targeted therapies for particular glioma subtypes. This review aims to summarize the current literature regarding glioma subclassifications and their clinical relevance in this evolving field.


Effects of phenothiazine neuroleptics on the rate of caffeine demethylation and hydroxylation in the rat liver.
The primary metabolic pathways of caffeine are 3-N-demethylation to paraxanthine (CYP1A2), 1-N-demethylation to theobromine and 7-N-demethylation to theophylline (CYP1A2 and other enzymes), and 8-hydroxylation to 1,3,7-trimethyluric acid (CYP3A). The aim of the present study was to investigate the influence of phenothiazine neuroleptics (chlorpromazine, levomepromazine, thioridazine, perazine) on cytochrome P-450 activity measured by caffeine oxidation in rat liver microsomes. The obtained results showed that all the investigated neuroleptics competitively inhibited caffeine oxidation in the rat liver, though their potency to inhibit particular metabolic pathways was not equal. Levomepromazine exerted the most potent inhibitory effect on caffeine oxidation pathways, the effect on 8-hydroxylation being the most pronounced. This indicates inhibition of CYP 1 A2 (inhibition of 3-N- and 1-N-demethylation; Ki = 36 and 32 microM, respectively), CYP3A2 (inhibition of 8-hydroxylations; Ki = 20 microM), and possibly other CYP isoenzymes (inhibition of 7-N-demethylation; Ki = 58 microM) by the neuroleptics. The potency of inhibition of caffeine oxidation by perazine was similar to levomepromazine. Thioridazine was a weaker inhibitor of caffeine 3-N- and 7-N-demethylation, while chlorpromazine was weaker in inhibiting caffeine 1-N- and 7-N-demethylation, compared to levomepromazine. In summary, the obtained results showed that all the investigated neuroleptics had a broad spectra of CYP inhibition in the rat liver. The isoenzymes CYP1A2 and CYP3A2 were distinctly inhibited by all the investigated neuroleptics, while other CYP isoenzymes (CYP2B and/or 2E1) by perazine and levomepromazine. The CYP3A2 inhibition was most pronounced. (Ki = 20-40 microM).


[Safe extraction of an impacted open safety pin from the esophagus: a new technique and five case studies].
Esophageal foreign bodies are common, especially in children less than 5 years old. However, the presence of an open safety pin in the esophagus is quite rare. When this occurs, immediate removal of the safety pin is recommended due to its propensity to pierce the esophagus and surrounding structures causing severe and sometimes even lethal complications. Between the years 1990 and 2003, fifteen infants were referred to the Department of Otolaryngology-Head and Neck Surgery at the Rambam Health Care Campus with a history of safety pin ingestion. Plain neck, chest and abdomen radiographs showed the presence of an open safety pin impacted in the esophagus and pointing upwards in nine of the cases, and in the remainder (six infants) a closed pin was demonstrated in the stomach or in the duodenum. This report focuses on five cases in which during esophagoscopy only the clasp of the safety pin was visible, whereas the sharp point was impossible to be grasped, as it seemed to be stuck in the mucosa of the esophagus. In these cases the pin was pushed into the stomach, where it was closed, and then it was pulled outside without any harm to the mucosa or the gastric and esophageal walls. We present a new technique on how to safely close an open safety pin in the stomach and remove it, without any complications, using a flexible endoscope.


Wood creosote inhibits calcium mobilization in Guinea pig colonic smooth muscle.
Wood creosote, a mixture of simple phenolic compounds, has long been used as an herbal antidiarrheal medicine. Previous studies have shown that wood creosote has antimotility activity on the gastrointestinal (GI) tract, although its mechanism of action is not completely understood. The in vitro efficacy of wood creosote on calcium mobilization in guinea pig colonic smooth muscle was evaluated using a digital video camera system mounted on an inverted fluorescence microscope. The effects of wood creosote on spontaneous periodic increases in the free cytosolic calcium concentration ([Ca(2+)](i)), acetylcholine (ACh)-enhanced periodic increases in [Ca(2+)](i), and tetrodotoxin- or nifedipine-resistant spontaneous periodic increases in [Ca(2+)](i) were evaluated. Wood creosote decreased the amplitude of spontaneous (IC(50)=21 microg/ml) and ACh-enhanced (IC(50)=40 microg/ml) periodic increases in [Ca(2+)](i) in guinea pig colonic smooth muscle. Wood creosote also decreased the amplitude of both tetrodotoxin- and nifedipine-resistant spontaneous periodic increases in [Ca(2+)](i). These results suggest that antimotility activity through inhibition of Ca(2+) mobilization in the GI tract is at least partially responsible for the antidiarrheal activity of wood creosote. Wood creosote may exert its antimotility effect, at least in part, on network regions of interstitial cells of Cajal, which act as pacemaker cells and mediators of neurotransmission in the GI tract.


Prevalence and Risk Factors of Low Birth Weight in the Southeast of Iran.
The purpose of this study was to determine the prevalence and related factors of low birth weight (LBW) in the Southeast of Iran. This cross-sectional study was carried out in Kerman province. Data were collected from Iranian Maternal and Neonatal Network at public and private hospitals. All live births from March 2014 to March 2015 considered as the source population. The risk factors including maternal age, gravida, parity, abortion, pregnancy risk factors, maternal nationality, maternal education, maternity insurance, place of living, consanguinity, neonate sex, preterm labor, place of birth, delivery manager, and delivery type were compared between LBW and normal birth weight groups. The prevalence of LBW was 9.4% in the present study. Preterm labor (odds ratio [OR]: 22.06; P < 0.001), neonate female sex (OR: 1.41; P < 0.001), low parity (OR: 0.85; P < 0.001), pregnancy age <18 years (OR: 1.26; P = 0.012), pregnancy age >35 years (OR: 1.21; P = 0.001), delivery by cesarean section (OR: 1.17; P = 0.002), pregnancy risk factors (OR: 1.67; P < 0.001), maternal illiteracy (OR: 1.91; P < 0.001), living in the rural area (OR: 1.19; P < 0.001), consanguineous (OR: 1.08; P = 0.025), and delivery by obstetrician (OR: 1.12; P = 0.029) were identified as significant factors associated with LBW in this study. Prevention of preterm labor, consanguineous marriage, pregnancy age <18 and >35 years old, and maternal medical risk factors are some critical interventions to reduce its burden. Increasing the access to high-quality health-care services in rural and deprived areas is another effective strategy for the prevention of LBW.


Hypophysitis: Evaluation and Management.
Hypophysitis is the acute or chronic inflammation of the pituitary gland. The spectrum of hypophysitis has expanded in recent years with the addition of two histologic subtypes and recognition as a complication of treatment with immune checkpoint inhibitors. Despite the increased number of published cases, the pathogenesis of hypophysitis is poorly understood, and treatment strategies are diverse and controversial. The diagnosis of hypophysitis generally requires histopathologic confirmation. The presentation and clinical course of hypophysitis varies. Hypophysitis can resolve spontaneously, relapse may occur, and some cases can be refractory to treatment.


L-741,494, a fungal metabolite that is an inhibitor of interleukin-1 beta converting enzyme.
gamma-Pyrone-3-acetic acid (L-741,494) is a novel metabolite produced by a culture of the fungal genus Xylaria. This substance is a water-soluble, competitive, irreversible inhibitor of Interleukin-1 beta Converting Enzyme that is inactive against papain and trypsin. It has a mol wt of 154 and an empirical formula of C7H6O4. We propose the name xylaric acid for this compound.


Magnetic resonance spectroscopy and magnetic resonance spectroscopic imaging in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy: A literature review.
This review focuses on the current literature directed towards the brain metabolite findings in Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) disease using magnetic resonance spectroscopy (MRS) and magnetic resonance spectroscopic imaging (MRSI). Using search terms "metabolites", "spectroscopy", and "CADASIL", six articles were found on PubMed database, Scopus and Google Scholar. Changes in metabolites concentrations and relative ratios (RR) were found not only in abnormal but also in normal-appearing brain regions.


Adenovirus-mediated arterial gene therapy for restenosis: problems and perspectives.
Restenosis remains the main limitation of interventional cardiology. Restenosis occurs when angioplasty-induced intimal hyperplasia as well as arterial remodelling result in flow-limiting renarrowing of the arterial lumen at the angioplasty site. Intimal hyperplasia is an important candidate for gene therapy since it is related to smooth muscle cell proliferation, which is an inviting target for molecular antiproliferative strategies. To date, adenoviral vectors are, by far, the most efficient vectors to perform in vivo arterial gene transfer. These vectors, as well as others, have been recently used to demonstrate that therapeutic genes encoding cytotoxic (herpes virus thymidine kinase) or cytostatic (hypophosphorylatable Rb, Gax, endothelial nitric oxide synthase) products successfully inhibit smooth muscle cell proliferation and related intimal hyperplasia. Despite substantial progress, major technical issues, including the toxicity of first-generation adenoviral vectors, inefficient transduction of atherosclerotic arteries, and the risk of extra-arterial transfection remain to be addressed before gene therapy is applied to clinical restenosis.


Effects of chlorine injury, starvation, and Colitag(TM) enrichment on sandwich enzyme-linked immunosorbent assay (sELISA) detection of Escherichia coli O157:H7.
The validity of ELISA for detection of E. coli O157:H7 under many conditions is not proven. In this work, sELISA was able to detect bacteria after sub-lethal chlorine exposure and after seven days of starvation with little to no change in limit of detection and fluorescence signal as long as chlorine was not present in the sample or was neutralized by sodium thiosulfate. After Colitag enrichment, sELISA detected approximately 3 colony forming units/ml of originally added E. coli O157:H7. Thus, the present sELISA is valid for detection of E. coli O157:H7 in water sources, although sample matrices may interfere with assay.


Occurrence and seasonal dynamics of RNA viral genotypes in three contrasting temperate lakes.
Decades of research have demonstrated the crucial importance of viruses in freshwater ecosystems. However, few studies have focused on the seasonal dynamics and potential hosts of RNA viruses. We surveyed microbial-sized (i.e. 5-0.2 μm) mixed community plankton transcriptomes for RNA viral genomes and investigated their distribution between microbial and macrobial plankton over a seasonal cycle across three temperate lakes by quantitative reverse transcriptase PCR (qRT-PCR). A total of 30 contigs bearing similarity to RNA viral genomes were recovered from a global assembly of 30 plankton RNA libraries. Of these, only 13 were found in >2 libraries and recruited >100 reads (of 9.13 x 107 total reads), representing several picornaviruses, two tobamoviruses and a reovirus. We quantified the abundance of four picornaviruses and the reovirus monthly from August 2014 to May 2015. Patterns of viral abundance in the >5 μm size fraction and representation in microbial-sized community RNA libraries over time suggest that one picornavirus genotype (TS24835) and the reovirus (TS148892) may infect small (<5 μm) eukaryotic microorganisms, while two other picornaviruses (TS24641 and TS4340) may infect larger (>5 μm) eukaryotic microorganisms or metazoa. Our data also suggest that picornavirus TS152062 may originate from an allochthonous host. All five viral genotypes were present in at least one size fraction across all 3 lakes during the year, suggesting that RNA viruses may easily disperse between adjacent aquatic habitats. Our data therefore demonstrate that RNA viruses are widespread in temperate lacustrine ecosystems, and may provide evidence of viral infection in larger eukaryotes (including metazoa) inhabiting the lakes.


Technique for removing cement between a fixed prosthesis and its substructure.
Failed restorations diagnosed with salvageable and subsequently reusable metal substructures that demand their separation can be clinically challenging to undertake without the risk of damaging either the super- or substructures. This article describes a technique to safely separate them from each other in order for the respective substructure to be reused in the fabrication of a newly reconstructed restoration and for the existing restoration to be reused as a provisional where appropriately indicated.


Boosting the Supercapacitance of Nitrogen-Doped Carbon by Tuning Surface Functionalities.
The specific capacitance of a highly porous, nitrogen-doped carbon is nearly tripled by orthogonal optimization of the microstructure and surface chemistry. First, the carbons' hierarchical pore structure and specific surface area were tweaked by controlling the temperature and sequence of the thermal treatments. The best process (pyrolysis at 900 °C, washing, and subsequent annealing at 1000 °C) yielded a carbon with a specific capacitance of 117 F g-1 -nearly double that of a carbon made by a typical single-step synthesis at 700 °C. Following the structural optimization, the surface chemistry of the carbons was enriched by applying an oxidation routine based on a mixture of nitric and sulfuric acid in a 1:4 ratio at two different treatment temperatures (0 and 20 °C) and different treatment times. The optimal treatment times were 4 h at 0 °C and only 1 h at 20 °C. Overall, the specific capacitance nearly tripled relative to the original carbon, reaching 168 F g-1 . The inherent nitrogen doping of the carbon comes into interplay with the acid-induced surface functionalization, creating a mixture of oxygen- and nitrogen-oxygen functionalities. The evolution of the surface chemistry was carefully followed by X-ray photoelectron spectroscopy and by N2 sorption porosimetry, revealing stepwise surface functionalization and simultaneous carbon etching. Overall, these processes are responsible for the peak-shaped capacitance trends in the carbons.


DNA methylation in mouse gametogenesis.
DNA methylation is involved in many biological processes and is particularly important for both development and germ cell differentiation. Several waves of demethylation and de novo methylation occur during both male and female germ line development. This has been found at both the gene and all genome levels, but there is no demonstrated correlation between them. During the postnatal germ line development of spermatogenesis, we found very complex and drastic DNA methylation changes that we could correlate with chromatin structure changes. Thus, detailed studies focused on localization and expression pattern of the chromatin proteins involved in both DNA methylation, histone tails modification, condensin and cohesin complex formation, should help to gain insights into the mechanisms at the origin of the deep changes occurring during this particular period.


Highly Enhanced Raman Scattering on Carbonized Polymer Films.
We have discovered a carbonized polymer film to be a reliable and durable carbon-based substrate for carbon enhanced Raman scattering (CERS). Commercially available SU8 was spin coated and carbonized (c-SU8) to yield a film optimized to have a favorable Fermi level position for efficient charge transfer, which results in a significant Raman scattering enhancement under mild measurement conditions. A highly sensitive CERS (detection limit of 10-8 M) that was uniform over a large area was achieved on a patterned c-SU8 film and the Raman signal intensity has remained constant for 2 years. This approach works not only for the CMOS-compatible c-SU8 film but for any carbonized film with the correct composition and Fermi level, as demonstrated with carbonized-PVA (poly(vinyl alcohol)) and carbonized-PVP (polyvinylpyrollidone) films. Our study certainly expands the rather narrow range of Raman-active material platforms to include robust carbon-based films readily obtained from polymer precursors. As it uses broadly applicable and cheap polymers, it could offer great advantages in the development of practical devices for chemical/bio analysis and sensors.


Immunomodulatory effects of a set of amygdalin analogues on human keratinocyte cells.
Peptide T (PT) is an octapeptide shown to resolve psoriatic lesions. Our previous investigations suggest that keratinocytes play an important role in conditioning the therapeutic effects of the PT in psoriasis. However, peptides are not good therapeutic agents, because they exhibit poor absorption, are easily metabolized and are immunogenic. Using computational methods, the natural product amygdalin was identified as peptidomimetic of PT. However, amygdalin exhibits a toxic profile due to its cyanide group. To overcome this deleterious effect, we synthesized analogues lacking the cyanide group. Human keratinocytes were treated with PT or with three different peptidomimetics of PT. To study its effects on the expression of HSP-70, TGF-beta, alpha-v integrin, ICAM-1 and cytokines, we analysed the protein levels by Western blot and ELISA. Our results show that the different peptidomimetics of PT tested exhibit a similar biological behaviour in regard to the overexpression of HSP-70, TGF-beta and alpha-v integrin than the native peptide. TNF-alpha is overexpressed by PT and SVT-03018; between the other two analogs, SVT-03016 do not produce any significant change in regard to the control, while SVT-03017 shows only a moderate increase in regard to control. SVT-03018 provokes a remarkable upregulation of IL-10, stronger than SVT-03016, SVT-03017 and PT. All the other three analogues reduce comparably to the PT, the expression of ICAM-1 and do not increase the release of proinflammatory cytokines. The results highlighted that the three analogues of amygdalin with the cyanide group removed exhibit the same biological effects of PT. Therefore, they can be considered peptidomimetics, suggesting their possible use in the treatment of psoriasis.


To speed or not to speed: Thematic analysis of American driving narratives.
Speeding is a major cause of unintentional roadway death in the United States. Existing data show that U.S. drivers tend to speed less as they age, but reasons for this change remain largely unknown. Limited research has examined why U.S. drivers decide to speed or why U.S. drivers decide not to speed, and none to date has determined why speeding behaviors change over the life course. Research into these issues can provide insight that may be harnessed for more effective anti-speeding interventions that catalyze decisions not to speed. The current study asked a national sample of U.S. drivers (N = 309) about their driving behaviors and how they have changed over time using an open-ended prompt in an online survey. The authors qualitatively coded responses using a narrative analysis lens to identify common themes. Results show U.S. drivers often make deliberate choices to speed and some do not consider speeding to be dangerous after achieving perceived mastery of driving skills. Participants tended to report speeding less over time, citing increased concern for family and other roadway users, which may help explain national speeding data trends. Several other themes emerged identifying individual cognitive factors, environmental contexts, and key persons impacting speeding decisions. Practical Applications: Findings show that the most effective means of encouraging U.S. drivers to decide not to speed may be multi-pronged intervention approaches highlighting how speeding reduces roadway driver control, connecting speeding with safety, and encompassing road design and law enforcement strategies.


Synthesis and study of the use of heterocyclic thiosemicarbazones as signaling scaffolding for the recognition of anions.
A family of heterocyclic thiosemicarbazone dyes (1-9) linked to different furan, thiazole, (bi)thiophene, and arylthiophene pi-conjugated bridges were synthesized in good yields, and their response toward anions was studied. Acetonitrile solutions of 1-9 show bands in the 326-407 region that are modulated by the electron-donor or -acceptor strength of the heterocyclic systems appended to the phenylthiosemicarbazone moiety. Anions of different shape such as fluoride, chloride, bromide, iodide, dihydrogen phosphate, hydrogen sulfate, nitrate, acetate, cyanide, and thiocyanate were employed for the recognition studies. From these anions, only fluoride, cyanide, acetate, and dihydrogen phosphate displayed sensing features. Two different effects were observed, (i) a low bathochromic shift of the absorption band due to coordination of the anions with the thiourea protons and (ii) the growth of a new red-shifted band with a concomitant change of the solution from yellow or pale yellow to orange-red due to deprotonation. The extent of each process is a balance between the acidity tendency of the thioureido-NH donors modulated by the donor or acceptor groups in the structure of the receptors and the basicity of the anions. Fluorescence studies were also in agreement with the different effects observed on the UV/vis titrations. Stability constants for the two processes (complex formation + deprotonation) for selected receptors and the anions fluoride and acetate were determined spectrophotometrically using the program HYPERQUAD. Semiempirical calculations to evaluate the hydrogen-donating ability of the dyes and (1)H NMR titrations experiments with fluoride were carried out. A prospective electrochemical characterization of compound 3 in the presence of anions was also performed.


Inhibition of rheumatoid arthritis by blocking connective tissue growth factor.
The pathogenesis of rheumatoid arthritis (RA) remains to be completely elucidated so far; however, it is known that proinflammatory cytokines play a pivotal role in the induction of RA. Tumor necrosis factor (TNF-α), in particular, is considered to play a central role in bone destruction by mediating the abnormal activation of osteoclasts or the production of proteolytic enzymes through direct or indirect mechanisms. The use of TNF-α blocking agents has a significant impact on RA therapy. Anti-TNF-α blocking agents such as infliximab are very effective for treatment of RA, especially for the prevention of articular destruction. We have previously shown that several proteins exhibited extensive changes in their expression after amelioration of RA with infliximab treatment. Among the proteins, connective tissue growth factor (CTGF) has a significant role for the development of RA. Herein, we review the function of CTGF in the pathogenesis of RA and discuss the possibility of a novel treatment for RA. We propose that CTGF is a potentially novel effector molecule in the pathogenesis of RA. Blocking the CTGF pathways by biological agents may have great beneficial effect in patients with RA.


Does sensory-processing sensitivity moderate the effect of household chaos on caregiver sensitivity? An experimental design.
Previous research has linked higher levels of household chaos to parenting problems, but it is not clear whether household chaos actually causes parenting problems. In this study, we used an experimental design in which levels of household chaos were manipulated to test the effect of household chaos on caregiver sensitivity. As sensory-processing sensitivity has been linked to the perception of household chaos, we also tested whether household chaos has a stronger effect on participants with higher sensory-processing sensitivity. Ninety-six young adults (nonparents) visited our lab twice and took care of an infant simulator in a lab furnished like a living room. In the neutral condition the room was orderly and calm, and in the chaos condition it was cluttered, noisy and smaller (order counterbalanced). Caregiver sensitivity was observed, and sensory-processing sensitivity was measured through questionnaires and observational data. Multilevel modeling showed caregiver sensitivity decreased over time in both conditions and that condition had a small effect on caregiver sensitivity, with sensitivity being lower in the chaos condition. We found that participants with higher sensory sensitivity decreased faster in the chaos condition than in the neutral condition. According to our findings, household chaos leads to less positive caregiving behavior and parents with higher sensory sensitivity may be more affected by household chaos. Thus, reducing household chaos may be effective in promoting positive parenting. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


The efficacy of mineralized allograft cortical and cancellous chips in maxillary sinus augmentations.
A mixture of mineralized allograft cortical and cancellous chips was used to augment the maxillary sinuses of 10 patients. Eleven sinus augmentation procedures were performed, and 19 bone cores were obtained at reentry after 6 to 7 months. Computed tomography at 6 months postaugmentation demonstrated bone formation in all sites. Light microscopic and histomorphometric evaluation confirmed bone formation at the treatment site that would receive osseointegrated implants to replace the missing maxillary posterior teeth. These encouraging results support the use of a mixture of mineralized allograft cortical and cancellous chips for sinus augmentation.


Primary Nonadherence to Overactive Bladder Medications in an Integrated Managed Care Health Care System.
Treatment for overactive bladder (OAB) remains suboptimal, in part because of patient nonadherence to medications. Primary nonadherence is when patients fail to pick up their initial prescriptions. To measure primary nonadherence to OAB medications within 30 days of a first OAB prescription order using electronic medical records from a U.S. managed care health care system METHODS: A retrospective cohort study was conducted using electronic medical records from the Kaiser Permanente Southern California (KPSC) database to identify patients with new OAB prescriptions between January 1, 2007, and December 31, 2013. The index date was defined as the first order of an OAB prescription. Patients had to be aged ≥ 18 years on the index date and were required to have 12 months of continuous membership with drug benefit eligibility before, during, and after the index date. Patients were defined as primary nonadherent if they did not pick up their new OAB prescriptions within 30 days of the order date. Descriptive statistics and a multivariable logistic regression analysis with backward selection were conducted to identify factors associated with patients who were primary nonadherent versus adherent. There were 9,050 patients with a new OAB prescription order; 1,662 (18%) of these were primary nonadherent. Patients with primary nonadherence were younger in age (56.9 [SD ± 16.0] years vs. 63.9 [SD ± 14.8] years; P < 0.001) and more likely to have commercial insurance (65.9% vs. 46.2%; P < 0.001). They also had lower mean Charlson Comorbidity Index (CCI) scores (1.99 vs. 2.70; P < 0.001), fewer OAB-related comorbidities, fewer concomitant medications (P < 0.005), and fewer overall prescriptions dispensed in the previous 12 months (P < 0.001) compared with adherent patients. Significant factors such as commercial insurance (P = 0.013), race other than white (P = 0.020), CCI = 0 versus CCI ≥ 2 (P = 0.001), urinary tract infections (P < 0.001), and falls (P = 0.047) were associated with a higher likelihood of primary nonadherence versus adherence. Nearly 1 in 5 patients did not pick up their new OAB medications within 30 days of the order date. Knowledge of factors associated with primary nonadherence may inform strategies for improving management of OAB. This study was supported by a research grant provided by Astellas Pharma Global Development. Rashid and Lin do not have any financial interests or potential conflict of interest with regard to the work. Vassilakis, Kristy, and Ng were employees of Astellas Pharma Global Development when this study was conducted. Study concept and design were contributed by Rashid and Ng, along with the other authors. Rashid and Lin collected the data, and data interpretation was performed by Rashid, Ng, and Lin, along with Vassilakis and Kristy. The manuscript was written by Rashid and Ng, along with Vassilakis and Lin, and revised by Rashid, Ng, and Lin.


Leiomyomatosis peritonealis disseminata: A case report and review of the literature.
Leiomyomatosis peritonealis disseminata (LPD) is a rare smooth muscle tumor, which is characterized by the dissemination of multiple smooth muscle-like nodules throughout the omental and peritoneal surfaces. The present report describes the case of a 33-year-old woman who had previously undergone laparoscopic myomectomy due to a bizarre leiomyoma. Five years after the initial operation, the patient was referred to our hospital with irregular episodes of right abdominal pain. As the presentation was highly suspicious of malignant uterine tumor metastasis or LPD, the patient subsequently underwent laparoscopic total hysterectomy, bilateral salpingo-oopherectomy, omental resection and excision of some of the disseminated nodules. Histological examination confirmed the diagnosis of LPD. Under laparoscopic examination, LPD must be distinguished from metastatic leiomyosarcoma and other malignant conditions. Frozen section biopsy examination may help with the diagnosis, but the final diagnosis relies on pathological examination. The etiology of LPD includes several theories, such as the hormonal, genetic and iatrogenic theories. A gonadotropin-releasing hormone agonist may be successful in shrinking the nodules. In women who have completed their families, total abdominal hysterectomy, salpingo-oophorectomy, omentectomy and debulking appears to be the optimal treatment.


[Anesthesia Management for Primary Cleft Lip Closure in an Infant with Congenital Total Length Complete Tracheal Rings].
Complete tracheal ring causes congenital tracheal stenosis in neonates and infants. We have to prevent further tracheal stenosis in perioperative period. This is a case report of an infant with congenital tracheal stenosis due to complete tracheal ring who underwent primary cleft lip closure under general anesthesia. An 8 month-old boy was scheduled for bilateral cleft lip closure. His first operation at two months was canceled because of unsuccessful intubation in previous hospital. He came to our hospital to seek a second opinion. His CT scan showed long segment stenosis of the trachea below glottis. The tracheobronchial endoscopy showed complete tracheal rings 1.5 cm below glottis to the bifurcation. Considering his aspiration episode, we decided to do the cleft lip closure promptly after examinations. We chose an ID 3.0 mm RAE tracheal tube, which is commercially narrowest We intubated 2 cm below glottis, and confirmed that the tip did not touch narrowed trachea with endoscope. This tube was fixed in the center of the mandible and packed with gauze. He was discharged on 8 POD without complication. CT scan and its integrated 3 D image of the trachea were useful to understand the approximate structure. However endoscopic examination allowed more detailed structure-measurement below glottis.


Dammarane-type saponins from leaves of Ziziphus spina-christi.
Phytochemical profiling of Ziziphus spina-christi leaves led to the characterization of 10 dammarane-type saponins and 12 phenolic compounds. Isolation was achieved by gel chromatography on Sephadex LH20, open column chromatography on silica gel, and semi-preparative HPLC with PDA and ELSD detectors. Structural characterization was performed by extensive 1D and 2D NMR, mass spectrometry, and by GC-MS of sugar derivatives. A biosynthetic pathway leading to three previously undescribed sapogenins is proposed. The saponin profiles in Z. spina-christi leaves of four different origins were compared by means of HPLC-ESIMS.


Pathogenesis of cardiovascular disorders in streptozotocin-induced diabetes in rat. II. Correlation between lipid peroxides, thromboxane A2/prostacyclin, and platelet aggregation in different stages of diabetes.
An attempt was undertaken to assess the relationship between the imbalance of lipid peroxides, thromboxane A2/prostacyclin and increased platelet aggregability during early (2 months) and late (6 months) stage of streptozotocin diabetes in rat. Thromboxane A2 and prostacyclin (PGI2) were estimated by their stable metabolic products TXB2 and 6-keto-PGF1 alpha respectively. The results showed: 1. There is a significant imbalance in TXA2 (a potent promoter of platelet aggregation) and PGI2 (a potent vasodilator and inhibitor of platelet aggregation). The ratio TXA2/PGI2 was increased by 38% in the early and by 69% in the late stage of diabetes. 2. Serum lipid peroxides increased significantly during early (four times) and late (five times) stage of diabetes. 3. There is a very good correlation between increased lipid peroxides and increased TXA2/PGI2 ratio (r = 0.71) in diabetic rats. 4. A pronounced increase in thrombin-induced platelet aggregation is consistent with the increased levels of lipid peroxides (r = 0.65) and TXA2/PGI2 ratio (r = 0.60). 5. All described changes correlate with the duration of the disease.


Predicting school dropout and adolescent sexual behavior in offspring of depressed and nondepressed mothers.
To examine predictors of school dropout and adolescent sexual behavior in offspring of depressed and nondepressed mothers. Possible moderators of the relation between maternal depression and these outcomes also were explored. Participants were 240 mothers and adolescents assessed annually from 6th through 12th grade. Interviews and questionnaires measured the chronicity and severity of the mother's depressive episodes, the mother's educational attainment, socioeconomic status, the presence of a father, the adolescent's IQ, externalizing behaviors, and substance use disorders. Substance use disorders before ninth grade significantly predicted higher rates of both school dropout and adolescent sexual behavior. Lower levels of mother's educational attainment and higher rates of adolescent's externalizing behaviors in grades 6 through 8 predicted higher school dropout. Higher IQ was associated with a lower likelihood of dropping out among offspring of never or moderately depressed mothers, but not for offspring of chronic/severely depressed mothers. Among offspring of never or moderately depressed mothers, the presence of a male head of household was associated with lower rates of adolescent sexual behavior, but not among offspring of chronically/severely depressed mothers. These findings have implications for the development of programs aimed at preventing behavior problems in high-risk adolescents.


T12-L1 telescoped chronic dislocation treated by en bloc one-piece spondylectomy and spine shortening.
The author presents a case in which a severe chronic thoracolumbar kyphotic posttraumatic deformity was corrected by a one-block spondylectomy with spine shortening, using a posterior approach. A 19-year-old paraplegic woman was admitted with a chronic deformity of the thoracolumbar spine due to a telescoped posterior dislocation of L1 on T12, which had occurred 8 months earlier. Single reduction by axial traction was impossible. Surgical correction was achieved by means of a total, one-block, L1 spondylectomy and end-to-end apposition of the T12 inferior platform onto the L2 superior platform. This was performed through a posterior approach. The reduction was fixed by a pedicular instrumentation extended from T10 to L4. To our knowledge, this is the first documented case in which the spondylectomy was performed in a single block including the vertebral body and posterior arch in the same piece. Five years following surgery, the clinical result is excellent with complete correction of the deformity and solid interbody vertebral fusion. The complete transection of the spinal cord permitted this aggressive approach, which would have not been possible in other types of pathology.


Quantitative image analysis pipeline for detecting circulating hybrid cells in immunofluorescence images with human-level accuracy.
Circulating hybrid cells (CHCs) are a newly discovered, tumor-derived cell population identified in the peripheral blood of cancer patients and are thought to contribute to tumor metastasis. However, identifying CHCs by immunofluorescence (IF) imaging of patient peripheral blood mononuclear cells (PBMCs) is a time-consuming and subjective process that currently relies on manual annotation by laboratory technicians. Additionally, while IF is relatively easy to apply to tissue sections, its application on PBMC smears presents challenges due to the presence of biological and technical artifacts. To address these challenges, we present a robust image analysis pipeline to automate the detection and analyses of CHCs in IF images. The pipeline incorporates quality control to optimize specimen preparation protocols and remove unwanted artifacts, leverages a β-variational autoencoder (VAE) to learn meaningful latent representations of single-cell images and employs a support vector machine (SVM) classifier to achieve human-level CHC detection. We created a rigorously labeled IF CHC dataset including 9 patients and 2 disease sites with the assistance of 10 annotators to evaluate the pipeline. We examined annotator variation and bias in CHC detection and then provided guidelines to optimize the accuracy of CHC annotation. We found that all annotators agreed on CHC identification for only 65% of the cells in the dataset and had a tendency to underestimate CHC counts for regions of interest (ROI) containing relatively large amounts of cells (>50,000) when using conventional enumeration methods. On the other hand, our proposed approach is unbiased to ROI size. The SVM classifier trained on the β-VAE encodings achieved an F1 score of 0.80, matching the average performance of annotators. Our pipeline enables researchers to explore the role of CHCs in cancer progression and assess their potential as a clinical biomarker for metastasis. Further, we demonstrate that the pipeline can identify discrete cellular phenotypes among PBMCs, highlighting its utility beyond CHCs.


Adaptation and validation of the Berlin questionnaire of competence in evidence-based dentistry for dental students: a pilot study.
The purpose of this pilot study was to create a valid and reliable set of assessment questions for examining Evidence-based Dentistry (EbD) knowledge. For this reason, we adapted and validated for dental students the Berlin Questionnaire (BQ), which assesses Evidence-based Medicine (EbM) abilities. The Berlin Questionnaire was validated with medical residents. We adapted it for use in a dentistry setting. An expert panel reviewed the adapted BQ for content validity. A cross-sectional cohort representing four training levels (EbD-novice dental students, EbD-trained dental students, dentists, and EbM-/EbD-expert faculty) completed the questionnaire. A total of 140 participants comprised the validation set. Internal reliability, item difficulty and item discrimination were assessed. Construct validity was assessed by comparing the mean total scores of students to faculty and comparing proportions of students and faculty who passed each item. Among the 133 participants (52 EbD-novice dental students, 53 EbD-trained dental students, 12 dentists, and 16 EbM-/ EbD-expert faculty), a statistically significant (p < 0.001) difference was evident in the total score corresponding to the training level. The total score reliability and psychometric properties of items modified for discipline-specific content were acceptable. Cronbach's alpha was 0.648. The adapted Berlin Questionnaire is a reliable and valid instrument to assess competence in Evidence-based Dentistry in dental students. Future research will focus on refining the instrument further.


Isotopic evidence for the spatial heterogeneity of the planktonic food webs in the transition zone between river and lake ecosystems.
Resources and organisms in food webs are distributed patchily. The spatial structure of food webs is important and critical to understanding their overall structure. However, there is little available information about the small-scale spatial structure of food webs. We investigated the spatial structure of food webs in a lake ecosystem at the littoral transition zone between an inflowing river and a lake. We measured the carbon isotope ratios of zooplankton and particulate organic matter (POM; predominantly phytoplankton) in the littoral zone of a saline lake. Parallel changes in the δ (13)C values of zooplankton and their respective POMs indicated that there is spatial heterogeneity of the food web in this study area. Lake ecosystems are usually classified at the landscape level as either pelagic or littoral habitats. However, we showed small-scale spatial heterogeneity among planktonic food webs along an environmental gradient. Stable isotope data is useful for detecting spatial heterogeneity of habitats, populations, communities, and ecosystems.


Outcomes after catheter ablation of ventricular tachycardia without implantable cardioverter-defibrillator in selected patients with arrhythmogenic right ventricular cardiomyopathy.
The roles of implantable cardioverter-defibrillators (ICDs) and radiofrequency catheter ablation (RCA) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and well-tolerated monomorphic ventricular tachycardia (MVT) are debated. In this multicentre retrospective study, we aimed at reporting the outcome of selected patients with ARVC after RCA without a back-up ICD. Patients with ARVC who underwent RCA of well-tolerated MVT at 10 tertiary centres across 5 countries, without an ICD before and 3 months after RCA, without syncope or electrical storm, and with left ventricular ejection fraction ≥50% were included. In total, 65 ARVC patients [mean age 44.5 ± 13.2 years, 78% males] underwent RCA of MVT between 2003 and 2016. Clinical presentation was palpitations in 51 (80%) patients. One (2%) patient had >1 clinical MVT. At the ablative procedure, clinical MVTs (mean rate 185 ± 32 b.p.m.) were inducible in 50 (81%) patients. Epicardial ablation was performed in 19 (29%) patients. Complete acute success was achieved in 47 (72%) patients. After a median follow-up of 52.4 months (range 12.3-171.4), there was no death or aborted cardiac arrest, and VT recurred in 19 (29%) patients. Survival without VT recurrence was estimated at 88%, 80%, and 68%, 12, 36, and 60 months after RCA, respectively, and was significantly associated with the approach and the procedural outcome. In patients with ARVC, well-tolerated MVT without a back-up ICD did not lead to fatal arrhythmic event after RCA despite VT recurrences in some. Our data suggest that RCA may be an alternative to ICD in selected ARVC patients.


Preoperative chemotherapy with a trastuzumab-containing regimen for a patient with gastric cancer and hepatic metastases.
Gastric cancer is the fourth most common cancer worldwide and the leading cause of tumor-related death in China. Gastric cancer is a heterogeneous disease and therefore requires different treatments based on the subtype. We describe a patient who had gastric cancer with liver metastases. Biopsy and tumor analysis using the HercepTest revealed a human epidermal growth factor receptor 2 (HER2)-positive adenocarcinoma as confirmed by fluorescence in situ hybridization. The patient was treated with a regimen of trastuzumab, oxaliplatin, and S-1 (six cycles). When positron emission tomography findings suggested that the metastases had resolved, the patient underwent surgery. Histopathologically, no cancer cells were observed in the resected hepatic tissue. The patient underwent tumor resection surgery, during which the tumor and gastric lymph nodes with lesions were removed. The patient has remained disease-free for 3 months. Therefore, trastuzumab may be an effective agent in the chemotherapeutic treatment of liver metastases in patients with HER2-positive gastric adenocarcinoma.


A Cationic Diode Based on Asymmetric Nafion Film Deposits.
A thin film of Nafion, of approximately 5 μm thickness, asymmetrically deposited onto a 6 μm thick film of poly(ethylene terephthalate) (PET) fabricated with a 5, 10, 20, or 40 μm microhole, is shown to exhibit prominent ionic diode behavior involving cation charge carrier ("cationic diode"). The phenomenon is characterized via voltammetric, chronoamperometric, and impedance methods. Phenomenologically, current rectification effects are comparable to those observed in nanocone devices where space-charge layer effects dominate. However, for microhole diodes a resistive, a limiting, and an overlimiting potential domain can be identified and concentration polarization in solution is shown to dominate in the closed state.


Acquired vulvar lymphangioma circumscriptum.
Lymphangioma circumscriptum (LC) is a benign dilation of lymph channels localized to the skin and subcutaneous tissues. It is generally localized in mouth mucosa, tongue, proximal regions of arms and legs, groin, axilla, and trunk. Primary vulvar involvement is very rare. Vulvar involvement occurs in various clinical settings. Here, two uncommon cases with giant lymphangioma circumscriptum mimicking genital warts will be presented: a 55-year-old female patient with extensive lymphangiectasic lesions and genital wart-like papular lesions in the vulva secondary to diffuse scrofuloderma scars and a 60-year-old female patient with verruca-like lesions secondary to chronic inflammation.


Comparison of transanal endoscopic microsurgery with or without neoadjuvant therapy and standard total mesorectal excision in the treatment of clinical T2 low rectal cancer: a meta-analysis.
Some clinical trials demonstrated local resection for clinical T1 rectal cancer was safe and effective. But for clinical T2 rectal cancer, the results were controversial. Neoadjuvant therapy (NT) is proven to reduce the opportunity of advanced rectal cancer recurrence in various researches. The objective of this Meta-Analysis was to evaluate the oncological outcomes of transanal endoscopic microsurgery (TEM) with or without NT comparing with conventional total mesorectal excision (TME) for the treatment of clinical T2 rectal cancer.To search for the relevant studies, an electronic search was done from the databases of Pubmed, Embase, and the Cochrane Library in this meta-analysis. We compared the effectiveness of transanal endoscopic microsurgery with or without NT and standard total mesorectal excision in the treatment of T2 Rectal Cancer. 1RCT and 3nRCTs including 121 TEM patients (TEM + NT: 59, TEM: 62) and 174 TME patients with T2 rectal cancer were retrieved. Compared with TME, there were no significant differences in the outcomes of local recurrence, overall recurrence, overall survival between TEM + NT group. However in compassion with TME, TEM without NT was associated with an increased local recurrence, overall recurrence, and a shorter overall survival, with individual ORs being 3.04 (95% Cl: 1.17-7.90; I2 = 0%), 5.67 (95% Cl: 1.58-20.38; I2 = 0%) and 0.12 (95% Cl: 0.02-0.65; I2 = 0%), respectively. Compared with TME, TEM after NT may be a feasible and safe organ preservative approach for patients with clinical T2 low rectal cancer. But for those without NT, TEM always seem be associated with worse oncological outcomes.


Physiotherapy and associated factors affecting mouth opening changes in noma patients during initial hospitalization at an MSF-supported hospital in Northwest Nigeria-A retrospective cohort study.
Noma is a rapidly progressing infection of the oral cavity, which can cause the disintegration of the cheek, nose and eye, in under a week. One of the most disabling sequelae is trismus, the restriction of mouth opening, which results in difficulties in speech, mastication, social feeding habits and maintenance of oral hygiene. Restriction of mouth opening among noma patients mostly begins during the transition between World Health Organisation (WHO) stage 3 (gangrene) and stage 4 (scarring) of the disease. This study aims to describe the impact of physiotherapy in noma patients hospitalised with stages 3 and 4 of the disease and to identify factors that influence change in mouth opening of noma patients. This study is a retrospective analysis of routinely collected data from patients admitted at Noma Children Hospital, Sokoto, Northwest Nigeria between 1 May 2018 and 1 May 2020. Eligible patients included stage 3 and 4 noma patients who had not undergone any surgical reconstruction or trismus release surgery but received physiotherapy assessment and treatment during initial hospitalization. Factors associated with a change in mouth opening were identified using paired t-test analysis, bivariate and multivariate analyses. The mean difference in the mouth opening from admission to discharge was 6.9mm (95% CI: 5.4 to 8.3, p < 0.0001). Increased number of physiotherapy sessions and patient age above three years were significant predictors of improvement in mouth opening (p-value 0.011, 0.001 respectively). Physiotherapy treatment received within an adequate number of physiotherapy sessions for stage 3 and 4 noma patients during the period of the first hospitalization is important and results in a significant increase in mouth opening. Hence, noma patients at these stages should routinely undergo physiotherapy as part of a holistic approach to treatment.


[Optimal time of surgery for acute adhesive small bowel obstruction].
To define optimal terms of surgery for acute adhesive non-strangulatory small bowel obstruction. The analysis included 703 publications from e-LIBRARI.RU (342 works) and NCBI (361 works) databases for acute adhesive intestinal obstruction. The vast majority of articles presented retrospective analysis of single-center experience. It has been established that short course of medication is predominantly used for acute adhesive intestinal obstruction in the Russian Federation. International studies point 2-5 days for conservative treatment. The advantages and disadvantages of short and long courses of medication were analyzed. Therefore, multicenter, prospective, randomized trial 'Comparison of early operative treatment (12-hour medication) and long-term conservative treatment (48 hours) for acute adhesive small bowel obstruction' (COTACSO) was planned and registered (Unique Protocol ID: 14121729). The study protocol involves clinical, laboratory and instrumental exclusion of strangulation, randomization and conservative treatment of 2 groups of patients for 12 and 48 hours. Patients will undergo surgical interventions if obstruction will be present by that date. The main endpoint is mortality rate in both groups. The end of the study is December 2020.


Surface engineering of poly(methylmethacrylate): Effects on fluorescence immunoassay.
The authors present surface engineering modifications through chemistry of poly(methylmethacrylate) (PMMA) that have dramatic effects on the result of surface-bound fluorescence immunoassays, both for specific and nonspecific signals. The authors deduce the most important effect to be clustering of antibodies on the surface leading to significant self-quenching. Secondary effects are attributable to the formation of sparse multilayers of antibody. The authors compare PMMA as an antibody support surface with ultraviolet-ozone oxidized PMMA and also to substrates that were, after the oxidation, surface modified by a four-unit poly(ethyleneglycol) carboxylic acid (PEG4), a branched tricarboxylic acid, and a series of carboxylic acid-terminated dendrimers, from generation 1.5 to 5.5. Fluorescence immunoassay and neutron reflectometry were used to compare the apparent antibody surface loading, antigen binding and nonspecific binding on these various surfaces using anti-human IgG as a model antibody, chemically coupled to the surface by amide formation. Simple physical adsorption of the antibody on PMMA resulted in a thick antibody multilayer with small antigen binding capacity. On the carboxylated surfaces, with chemical coupling, a simple monolayer was formed. The authors deduce that antibody clustering was driven by conformational inflexibility and high carboxylate density. The PEG4-modified surface was the most conformationally flexible. The dendrimer-modified interfaces showed a collapse and densification. In fluorescence immunoassay, the optimal combination of high specific and low nonspecific fluorescence signal was found for the G3.5 dendrimer.